The St. Mary's Regional Medical Center's Department of Orthopedics offers expertise in the diagnosis and treatment of acute and chronic problems of the hand, shoulder, and upper extremity, including

• work-related and other traumatic injuries
• arthritis (rheumatoid and degenerative)
• carpal tunnel syndrome
• congenital hand injuries and deformities
• upper extremity pain problems
• reconstruction following trauma
• rotator cuff disorder
• arthritis (replacement surgery)
• fractures, dislocations, instability

Evaluation and treatment of all fractures and dislocations of all joints of the body, the extremities and spine.

The foot and ankle service offers expertise in the diagnosis and treatment of problems of the foot and ankle, with emphasis on adult reconstruction and revision surgery, traumatic and post-traumatic problems; congenital and developmental disease and deformities, including:

• forefoot abnormalities, deformities, or painful conditions;
• midfoot and hindfoot deformities (congenital, developmental or arthritic);
• tendon and ligament problems (traumatic or degenerative);
• diabetic foot evaluation and care (bracing, fusion, amputation, etc);
• ankle fractures, arthritis, instability, deformities
• treatment of non-united fractures (Ilizarov technique, grafts, internal fixation, electrical stimulation.
• reconstruction of traumatic, developmental or congenital deformities

Evaluation and treatment of sports related injuries and overuse syndromes, rehabilitation, arthroscopic knee and shoulder surgery and anterior cruciate ligament reconstruction.

A total hip replacement is a surgical procedure whereby the diseased cartilage and bone of the hip joint is surgically replaced with artificial materials. Total hip replacements are performed most commonly because of progressively severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is degenerative arthritis (osteoarthritis) of the hip joint. This type of arthritis is generally seen with aging, congenital abnormality of the hip joint, or prior trauma to the hip joint. Other conditions leading to total hip replacement include bony fractures of the hip joint and death (necrosis) of the hip bone. Hip bone necrosis can be caused by fracture of the hip, drugs (such as alcohol or corticosteroids), diseases (such as systemic lupus erythematosus), and conditions (such as kidney transplantation).

The progressively intense chronic pain together with impairment of daily function including walking, climbing stairs and even arising from a sitting position, eventually become reasons to consider a total hip replacement. Because replaced hip joints can fail with time, whether and when to perform total hip replacement are not easy decisions, especially in younger patients. Replacement is generally considered after pain becomes so severe that it impedes normal function despite use of anti-inflammatory medications. A total hip joint replacement is an elective procedure, which means that it is an option selected among other alternatives.

Total knee replacement is generally done when a person has a severe degenerative joint disorder such as osteoarthritis in which the articular, or moving, surfaces of the knee deteriorate, leading to severe pain, limitation or loss of function and/or deformity of the joint. The surgery is also performed to replace a badly fractured knee and when previous joint replacements have failed. Bilateral replacement means that both knees are replaced at the same time.

Other treatments are usually used before knee replacement surgery. These include:

• acetaminophen or anti-inflammatory drugs if the joint has degenerated
• a procedure called synovectomy, which is
• surgical removal of inflamed synovial tissue, the tissue that lubricates moving parts of a joint, osteotomy, which is restructuring of the bones to shift stresses from diseased tissue to more healthy tissue