ORTHOPAEDICS

Bone and Joint Problems Affect Everyone

Our Orthopaedic Surgeons provide a wide range of services to help diagnose and treat conditions of the musculoskeletal system for both men and women, including the following:

GENERAL ORTHOPEDIC CONDITIONS

There are several orthopedic conditions and injuries that can affect different parts of the body. Here you will find information on orthopedic conditions that are not always specific to one area. For each condition, we provide detailed information about the causes, what signs and symptoms you might experience, how a diagnosis can be made, and recommended treatment.
The following are some general orthopedic conditions:

  • Arthritis – We provide treatment for the most common types of arthritis, including osteo, rheumatoid, gout, psoriatic, septic, post-traumatic, and lupus
  • Bursitis – Bursitis is an inflammation of the fluid-filled sacs between the tendons and muscles, or bones in the hip, elbow, or shoulder
  • Fractures & Broken Bones – We treat fractures and broken bones caused by injuries
  • Sprains & Strains – We offer comprehensive care for sprains and strains
  • Tendonitis – This is an inflammation of the tendon that commonly occurs in the heels, knees, shoulders, wrists, and elbows

SHOULDER TREATMENTS

Shoulder pain can have many causes. It could begin due to trauma like a fall or accident, come from a condition like arthritis or tendonitis, or the shoulder could be injured by overuse.

We have a multi-faceted approach to shoulder pain, conditions and injuries treatment to relieve associated pain and improve function. We start with the least invasive treatment, but we also are highly trained in surgery should it be needed.

Our orthopedic physicians specializing in treating shoulder injuries and conditions have undergone residency, fellowship, and continuing education training.
Common shoulder injuries and conditions we treat:

  • Arthritis
  • Bursitis
  • Chronic pain
  • Dislocated shoulder
  • Rotator cuff tear
  • Fractures
  • Frozen shoulder
  • Inflamed shoulder (shoulder impingement)
  • Instability
  • Polymyositis (PM)
  • Reflex sympathetic dystrophy (RSD) pain disorder
  • Shoulder separation
  • SLAP tear
  • Sports injuries
  • Sprains and strains
  • Tendonitis especially bicep tendonitis
  • Cortisone Injection

For shoulder pain, the most common injection is a cortisone shot to relieve swelling and pain. Cortisone is a steroid that can be administered at the doctor’s office and can provide immediate relief. Cortisone shots can last for multiple months.

Surgical Treatments

In some cases of shoulder pain and injury, surgery will need to be performed if the injury is too severe from the start or if the conservative treatment options are not reducing the pain. Below are the main shoulder surgical treatments performed at CHP.

Rotator cuff repair
A rotator cuff repair is one of the most common surgical procedures for the shoulder. During the operation, the surgeon will be looking to identify the damaged part of the rotator cuff and restore the tendon by cleaning up and reattaching the torn and damaged tendons. This can be done in one of three ways listed below.

Arthroscopic repair

During this treatment, the surgeon will make small incisions and use an arthroscope (tiny camera) and tools to reattach the torn tendon.

Open repair:
This treatment option is also known as the traditional approach. The surgeon will repair the tendon through an incision that is several inches long. The deltoid muscle will need to be detached for the surgeon to have a better view of the shoulder and gain access to the torn tendon.

Mini-open repair:

This procedure starts arthroscopically when the surgeon removes bone spurs and treats other structures within the joint. Then the surgeon will use a small incision to repair the tendon. The benefit of this option is that it avoids the need to detach the deltoid muscle.

Arthroscopic Subacromial Decompression
This is a treatment option for shoulder impingement syndrome, which is an injury to the muscles between the bones in the shoulder. The surgery starts with the arthroscope entering the shoulder joint. Once in the joint, the surgeon looks for tears in the muscles, tendons, and ligaments. After the joint is examined the physician will smooth off spurs that are contributing to inflammation and impingement on the rotator cuff.

Arthroscopic Shoulder Stabilization

This surgery is needed when the shoulder is considered unstable, meaning it dislocates frequently or slips partially out of the joint. When surgery is needed the common treatment option is the arthroscopic shoulder stabilization approach. This surgery uses arthroscopy to reattach the loose or torn ligaments to the joint using implants called suture anchors. These anchors will relocate, tighten and hold in place injured joints. Over time the sutures will disintegrate.

Shoulder Replacement Surgery

According to the Agency for Healthcare Research and Quality, in 2011 about 53,000 people in the United States underwent shoulder replacement surgery.
There are multiple types of shoulder replacement surgeries, also known as shoulder arthroplasty. An orthopedic surgeon will decide on the best option depending on the type of damage, symptoms and patient’s age.

Total shoulder replacement: The entire shoulder joint is replaced with an artificial ball and socket.
Reverse shoulder replacement: An orthopedic surgeon will change the position of the ball and socket joint when placing the prosthetics. This treatment is ideal for patients with large rotator cuff tears and for those with cuff tear arthropathy, also known as shoulder arthritis. After surgery, the deltoid muscle controls the arm and not the rotator cuff.
Partial shoulder replacement or stemmed hemiarthroplasty: In this treatment option the ball aspect of the shoulder joint is repaired with an artificial ball.
Resurfacing hemiarthroplasty: The surgeon will replace the joint surface of the humeral head with a prosthesis cap. The advantage of this surgical option is that it preserves the bone. This is helpful for young or active patients to avoid the risk of artificial replacements wearing or loosening.

HIP SURGERY & ORTHOPEDIC TREATMENTS

If a person’s hip is damaged, everyday activities such as putting on shoes, walking and getting in and out of a chair may be difficult and painful. For some people with hip damage, even resting can cause discomfort.
We take a multi-faceted approach to treating hip pain and injuries, beginning with the least invasive and simplest solutions. We start with conservative treatments such as medication and lifestyle changes. We will also look at alternative treatments including physical therapy and different types of injections (such as cortisone and platelet-rich plasma).
Common hip injuries & conditions we treat:

  • Arthritis
  • Bursitis
  • Femoroacetabular impingement (FAI)
  • Fractures
  • Failed hip replacement
  • Infected total hip replacement
  • Need for a total hip replacement
  • Hip and prosthetic dislocation
  • Leg length discrepancy
  • Labral tears
  • Osteonecrosis (avascular necrosis)
  • Removal of loose fragments of cartilage in the joint
  • Sprain and strains
    Tendonitis

Hip Replacement & Hip Replacement Revision

At CHP we offer a range of hip replacement surgeries, as well as hip replacement revision surgeries that correct problems with a previous hip replacement. Each patient will meet with an orthopedic surgeon and go over the differences in the treatment options and find the best solution for them. Below is a very brief overview, and it is best to discuss your case with one of our surgeons.Total hip replacement, also known as total hip arthroplasty, is completed through an incision on the side of the hip that is between 10- to 12-inches. The muscles are detached or split from the hip. This allows the surgical team to fully view and dislocate the hip. The damaged bone or cartilage will be removed and replaced with prosthetic components commonly made of metal, plastic or ceramic materials. Minimally invasive total hip replacement surgery is similar to the total hip replacement process but there is less cutting of the tissue surrounding the hip. The surgery can be performed with one or two smaller incisions.

Anterior minimally invasive hip replacement surgery involves an incision through the front of the hip allowing the surgeon to reach the joint by separating rather than cutting and reattaching muscles. This allows for more aggressive rehabilitation after surgery.

Robotic Assisted computer navigation hip replacement is available at CHP. A computer navigation hip replacement is not completed by a robot but rather a computer that provides the surgeon with accurate information that assists in the surgery. This technology has reduced implantation-related complications by improving the placement, ligament balance, and leg length.

Failed hip replacement revision is a surgery to revise previous hip replacement. A hip replacement can fail for a number of reasons, including wearing out over time, infection, fractures, etc. The revision surgery can take many forms, such as revising only some elements of the artificial hip, removal and replacement of the whole prosthetic hip, and complete removal along with rebuilding segments of the bone with materials or a bone graft.

 

Fracture Treatment & Repair

When a patient fractures his or her hip there are multiple different treatment options depending on where the fracture is and the patient’s current health. Treatment for a hip fracture should be done as close to the time of the injury as possible. We will find the best option for any patient coming in with a hip fracture.

 

KNEE TREATMENT

Knee pain is a common complaint for people of all ages. It can be caused by a trauma or a medical condition. Medical conditions that cause knee pain include gout, infections, arthritis and being overweight or obese. Common trauma includes ligament or cartilage injuries, fractures, and muscle or tendon injuries.

Patients with knee problems typically experience pain, swelling, stiffness, weakness or instability in the joint. They may also hear crunching or popping noises or have the inability to fully bend or straighten the knee.

Some minor knee injuries can be treated with home treatment options, including rest, ice and over-the-counter anti-inflammatory pills. But many cases of knee pain require medical assistance.

Our orthopaedic team takes a multi-faceted approach to treating knee conditions, injuries and the pain resulting from either. We provide all options and offer the least invasive option to treat each patient’s knee issue.

Common knee problems we treat that can cause knee pain:

  • Anterior cruciate ligament (ACL) tears, ruptures & sprains
  • Arthritis
  • Knee (prepatellar) bursitis
  • Bone chips
  • Cartilage wear and tear
  • Chronic knee pain
  • Knee fracture
  • Iliotibial (IT) band syndrome
  • Meniscus tears
  • Osgood-Schlatter disease
  • Osteochondritis dissecans
  • Runner’s knee
  • Infected knee replacement
  • Failed knee replacement
  • Sprains & strains
  • Subluxation or dislocation
  • Tendonitis

Knee Replacement & Knee Replacement Revision
Our doctors will go over all the differences in each knee replacement surgery and pick the best option for each patient. We also offer knee replacement revision surgeries to correct problems with a previous knee replacement. A patient is a candidate for a knee replacement if there is severe destruction of the knee joint that is associated with pain and reduced function.

Total knee replacement is a surgery where the knee joint is replaced with a prosthetic joint made of artificial material. We often perform a minimally invasive total knee replacement, which is done with a 4 to 6-inch incision instead of the 8 to 11-inch incision used with a traditional total knee replacement surgery. This option also spares or minimally cuts the quadriceps muscles and tendon, leading to a quicker and less painful recovery.

Along with a minimally invasive approach, we may utilize computer guidance for joint implant placement. This is not a robotic surgery, rather the surgeon uses information from the computer to help with precise placement.

Arthroscopic Treatment Options

Arthroscopy is a surgical procedure our orthopedic surgeons use to view, diagnose and treat a problem inside the knee. In an arthroscopic procedure, a surgeon will make small incisions around the knee and insert a small camera lens and light (the arthroscope) for viewing and special surgical instruments to perform the operation. Arthroscopic procedures have a shorter downtime for patients and less reported pain.

Some of our most common arthroscopic knee surgeries include:

  • Meniscal repair procedures
  • ACL reconstruction
  • Knee cartilage restorative procedures

Physical Therapy

Physical therapists can help reduce pain and strengthen muscles to make the knee more stable. They can also confirm exercises are done correctly to reduce further injury. Physical therapy will also be used as an essential part of rehabilitation after surgery, should that be necessary.

Braces

For some causes of knee pain, a physician can provide a brace that can help support and protect the knee. Our doctors can help find the best brace, whether it is for preventive care, rehabilitative care, daily use or sports.

njections

In some cases, treatment options prior to surgery include injecting medication or other substances directly into the knee joint. Some injections offered at CHP include the following.

  • Corticosteroids: A steroid and a local anesthetic mixture is injected into the knee joint to treat knee pain, inflammation, and swelling with fluid buildup in the knee.
  • Platelet-rich plasma (PRP): This alternative treatment option uses platelets from the patient’s blood to promote cell restoration to repair damaged muscles, cartilage, tendons, ligaments or even bone in order to reduce pain and swelling.
  • Bone Marrow Injections: This injection uses a patient’s progenitor cells to initiate healthy growth of damaged tissue to decrease pain and improve function.
    Hyaluronic acid: Treats pain caused by osteoarthritis by using a substance similar to what naturally occurs in the joints as a lubricant and shock absorber.

SPORTS MEDICINE PROGRAM

Orthopaedic Specialists provides a sports medicine program for professional, college, high school, club level, and weekend warrior athletes to enhance their athletic and orthopedic care through streamlined communication with coaches, athletic trainers, and the patients themselves.

A Comprehensive Approach to Sports Medicine
Athletes’ medical needs and concerns often go beyond injury treatments. Our Orthopaedic Specialists offers a comprehensive sports medicine program to meet these needs providing our patients with continuity of care. Our sports treatment services include:

  • Musculoskeletal and orthopedic injury treatment and rehabilitation
  • Advanced concussion management and neuropsychiatric testing
  • Pre-participation physical exams
  • Exercise fitness testing and exercise prescription
  • Diagnosis and management of acute and chronic musculoskeletal issues
  • Exercise prescriptions for patients who are pregnant or have chronic medical conditions, such as diabetes or cardiac disease
  • Addressing medical concerns related to sports participation, including eating disorders, exercise-induced asthma, and skin conditions
  • Immediate Attention for Sports Injuries
  • Sports injuries can happen as a result of accidents, overuse or even inadequate athletic gear or equipment. Common sports injuries treated by our physicians include:
  • Sprains, strains, and other soft tissue injuries
  • Knee injuries
  • Fractures
  • Dislocations
  • Repetitive stress injuries

Our injury treatment program offers a direct line for athletic trainers and immediate appointments for injured athletes. We also offer in-office diagnostic imaging with X-rays and MRIs, physical therapy and rehabilitation, and custom bracing.


ELBOW TREATMENTS

Elbow surgery and other nonsurgical treatments could be needed for a range of reasons, including elbow pain and injury. The elbow is especially susceptible to stress injuries either acutely, as the result of a specific one-time injury, or over time as the result of overuse and repetitive injuries. There are many sports, hobbies, and jobs that require repetitive movements of the arm and elbow that can cause wear and pain.

CHP Orthopaedic Specialists takes a multi-faceted approach to treating elbow pain and elbow injury. Treatment will vary depending on the cause and severity of the symptoms and may include conservative treatment, injections, or surgical management.

We have a highly trained orthopedic surgeon team that specializes in elbow surgery and can effectively correct the most complex issues.

Common conditions we treat include:

  • Arthritis
  • Bone spurs (osteophytes)
  • Bursitis
  • Cubital tunnel syndrome (ulnar neuropathy)
  • Dislocation
  • Fractures
  • Golfer elbow (medial epicondylitis)
  • Tennis elbow (lateral epicondylitis)
  • Little League elbow (pitcher’s elbow or medial apophysitis)
  • Osteochondritis dissecans
  • Ruptured biceps or triceps tendon
  • Sprains and strains
  • Tendonitis

ORTHOPEDIC TRAUMA CARE

Injuries are deemed traumatic when they occur quickly and require immediate medical attention. When traumatic injuries involve broken bones, dislocations, and/or damage to muscles, ligaments, and tendons, an orthopedic trauma surgeon is called in to treat those conditions.


What is a Traumatic Injury?

Falls, motor vehicle crashes, sports injuries, and many other accidents can result in traumatic injuries that may require anywhere from basic to critical care. Sometimes these situations are life or limb threatening and require a team approach. When such incidents involve orthopedic injuries, it calls for a specially trained orthopedic trauma surgeon who can provide surgical and nonsurgical treatment. Not all orthopedic traumas are life threatening but can be life altering with lasting effects if left untreated.