Surgery
Our Surgeons and the team at Pacific Crest Orthopedics have been expertly trained at top-tier institutions to provide excellent surgical treatment. The team carefully weighs each patient and injury individually to find a non-surgical or surgical plan that works best for them. Depending on the injury, surgery may be considered to aid in maintaining as active of a lifestyle as possible and to prevent any further complications from the injury. Below are some of the most common surgical procedures, but please call our office or schedule a surgical consultation to discuss options tailored to you and your injury.
Meet our surgeons and learn more about their approach.
Shoulder Surgery
Dr. Ephraim Dickinson specializes in many other surgical procedures of the shoulder including: subacromial decompression, distal clavicle excision, biceps tenodesis, SLAP repair, pectoralis tendon repair, and debridement of calcific tendonitis. Please contact Pacific Crest Orthopedics if you’d like to discuss any of the above procedures.
Shoulder arthroscopy is a form of minimally invasive surgery that uses two small incisions in the shoulder to pass a miniaturized camera into the joint. A surgeon can use this technique to diagnose the cause of shoulder pain, and can also perform corrective procedures at the same time using minimally invasive instruments. Arthroscopic surgery is the basis of most shoulder procedures involving the cartilage, labrum, shoulder impingement, or rotator cuff injury.
After The Surgery : Shoulder arthroscopy is a standard procedure with a low complication rate. Shoulder arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a sling.
The shoulder is the most flexible joint in the body and consists of one major joint called the glenohumeral joint where the humeral head means the socket of the scapula, called the glenoid. In some people, over time, the cartilage between these two bones can wear down, causing osteoarthritis. This can cause pain, decrease range of motion, and can limit function. This is typically treated with conservative measures, but over time if someone’s activities of daily living continue to be limited then a shoulder arthroplasty, or total shoulder replacement, may be recommended.
A total shoulder arthroplasty is done under general anesthesia. This procedure begins with an incision and a gentle separation of the muscles and bones of the shoulder joint. The damaged humeral head is cut, hollowed out and then filled with cement. A new metal ball with a stem is placed in the bone. On the other side of the joint, near the glenoid, an artificial component is also implanted. Finally, the capsule of the shoulder, muscle and skin are carefully closed with stitches.
Reverse total shoulder arthroplasties are similar to total shoulder arthroplasties but are used in patients with both osteoarthritis of the shoulder and a rotator cuff tear. Instead of placing the metal ball in the humeral head and the cup in the glenoid as in a total shoulder, the metal ball and cup are switched. This allows patients with rotator cuff tears to use their deltoid muscle instead of the rotator cuff to continue to have full ROM of shoulder.
After this procedure, the patient is typically kept in the hospital for 24 hours and began on pain medications and antibiotics to prevent infection. Afterwards, they are placed in a sling, and are able to gently begin returning to activities with the aid of an expert physical therapist. Therapy typically takes about 3-6 months after surgery.
The rotator cuff consists of four tendons called the supraspinatus, infraspinatus subscapularis, and teres minor that help stabilize the shoulder and aid in strength and overall range of motion of the shoulder. A rotator cuff injury includes partial or complete tearing of the tendons of the rotator cuff. An acute injury generally causes rotator cuff tears, but, in some cases, more chronic tears can be associated with age-related degenerative changes, overuse, and daily wear and tear over time. Injuries to the rotator cuff can cause pain and weakness of the shoulder and can occasionally require surgery. Advanced minimally invasive arthroscopic techniques have been created for rotator cuff repair. They involve visualizing the shoulder arthroscopically then using sutures to anchor the tendon to the bone. Afterwards, patients are typically gently aided in returning to strengthening and ROM exercises with the help of an expert physical therapist.
A total shoulder arthroplasty is done under general anesthesia. This procedure begins with an incision and a gentle separation of the muscles and bones of the shoulder joint. The damaged humeral head is cut, hollowed out and then filled with cement. A new metal ball with a stem is placed in the bone. On the other side of the joint, near the glenoid, an artificial component is also implanted. Finally, the capsule of the shoulder, muscle and skin are carefully closed with stitches.
Reverse total shoulder arthroplasties are similar to total shoulder arthroplasties but are used in patients with both osteoarthritis of the shoulder and a rotator cuff tear. Instead of placing the metal ball in the humeral head and the cup in the glenoid as in a total shoulder, the metal ball and cup are switched. This allows patients with rotator cuff tears to use their deltoid muscle instead of the rotator cuff to continue to have full ROM of shoulder.
After this procedure, the patient is typically kept in the hospital for 24 hours and began on pain medications and antibiotics to prevent infection. Afterwards, they are placed in a sling, and are able to gently begin returning to activities with the aid of an expert physical therapist. Therapy typically takes about 3-6 months after surgery.
The labrum is the cup shaped rim of cartilage that sits on the glenoid and reinforces the bones of the shoulder. The labrum can get torn in acute injuries or over time due to repetitive use or wear and tear of the shoulder. Depending on the tear, the biceps tendon can also be affected. This is called a SLAP tear. Depending on extent of the tear and on symptoms, a labral tear is typically treated conservatively beginning with rest, physical therapy, anti-inflammatories, and possibly a corticosteroid injection. If symptoms do not improve then a labral repair or capsulorraphy may be recommended.
A labral repair is a minimally invasive arthroscopic surgery where the portion of the labrum that is torn is removed or repaired. In cases of a SLAP tear, where the biceps tendon is affected, absorbable sutures are used to also repair the biceps tendon. After the surgery patients may be placed in a sling, then will gradually return to range of motion and strengthening exercises.
The labrum is the cup shaped rim of cartilage that sits on the glenoid and reinforces the bones of the shoulder. The labrum can get torn in acute injuries or over time due to repetitive use or wear and tear of the shoulder. Depending on the tear, the biceps tendon can also be affected. This is called a SLAP tear. Depending on extent of the tear and on symptoms, a labral tear is typically treated conservatively beginning with rest, physical therapy, anti-inflammatories, and possibly a corticosteroid injection. If symptoms do not improve then a labral repair or capsulorraphy may be recommended.
A labral repair is a minimally invasive arthroscopic surgery where the portion of the labrum that is torn is removed or repaired. In cases of a SLAP tear, where the biceps tendon is affected, absorbable sutures are used to also repair the biceps tendon. After the surgery patients may be placed in a sling, then will gradually return to range of motion and strengthening exercises.
Knee Surgery
Dr. Ephraim Dickinson specializes in many other surgical procedures of the knee including: MCL reconstruction, PCL reconstruction, posterolateral corner reconstruction, tibial tubercle osteotomy, tibial plateau fracture repair, MPFL reconstruction, mensical transplant, osteochondral allograft, and OCD lesion repair. Please contact Pacific Crest Orthopedics if you’d like to discuss or schedule any of the above procedures with one of our expert surgeons.
Knee arthroscopy is a form of minimally invasive surgery that uses a small incision in the knee to pass a miniaturized camera into the joint. A surgeon can use this technique to diagnose the cause of knee pain, and can also perform corrective procedures at the same time using minimally invasive instruments. Arthroscopic surgery is the basis of most knee procedures involving the cartilage, meniscus, or cruciate ligaments.
Once a diagnosis is made, the surgeon can treat and repair the problem in the knee using various instruments through the arthroscopic ports. Repairs can include cartilage repair, meniscal repair or removal, removal of baker’s cyst, removal of loose fragment of bone, removal of medial plica, and aiding in reconstruction or repair of a torn cruciate ligament.
After the surgery: Knee arthroscopy is a standard procedure with a low complication rate. Knee arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a brace.
The anterior cruciate ligament (ACL) is one of key stabilizers within the knee and can get injured in pivoting injuries involving skiing, soccer, basketball or other sports. Depending on the patient’s age and activity level the surgeon may recommend surgical fixation. Many full ACL tears in young active people are treated with arthroscopic surgical repair and graft placement.
ACL reconstructions are outpatient procedures that involve a minimally invasive knee arthroscopy followed by a graft placement. Grafts include cadaver tendon, patellar tendon or hamstring tendon. Graft choice is a careful individual decision that is made together by the surgeon and patient.
After the surgery: There is a recovery process that includes careful guidance by an expert physical therapist. Over time these patients return to a healthy, full, active lifestyle.
Once a diagnosis is made, the surgeon can treat and repair the problem in the knee using various instruments through the arthroscopic ports. Repairs can include cartilage repair, meniscal repair or removal, removal of baker’s cyst, removal of loose fragment of bone, removal of medial plica, and aiding in reconstruction or repair of a torn cruciate ligament.
After the surgery: Knee arthroscopy is a standard procedure with a low complication rate. Knee arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a brace.
The meniscus is a piece of cartilage in your knee that stabilizes the joint and helps cushion it from impact and twisting motions. The meniscus is one of the most commonly affected tissues in the knee and is susceptible to tearing if the knee joint gets twisted during physical activities. A torn meniscus can cause chronic pain and may need surgical fixation if symptoms continue despite conservative measures.
Using a minimally invasive arthroscopic procedure the surgeon can visualize the meniscus and further define the type, location, and extent of the tear. As the meniscus helps protect the knee from arthritis, the goal of the surgeon is to always repair the meniscus when possible. If the meniscus is repairable, a small suture will be placed. Depending on the type of tear and if repair is not possible, a portion of the meniscus that is torn and causing symptoms may be removed, called a meniscectomy.
After the surgery: Most patients are discharged the same day after this procedure. If meniscal repair was possible then the patient is placed in a knee brace for 6 weeks and will begin a gradual return to activity. After a meniscectomy patient will work with an expert physical therapist to gradually return to activity without a knee brace.
Cartilage in your knee absorbs shock and allows for smooth movement. Common cartilage injuries include damage to the articular cartilage, which covers the ends of your leg bones, or a tear in the wedge-shaped cartilage between your leg bones called the meniscus.
Depending on the type of tear, debridement or replacement may be recommended. Common procedures involve the Matrix-associated autologous chondrocyte implantation (MACI) or others. Dr. Ephraim Dickinson and the team at Urgently Ortho are here to discuss the best option on an individual basis.
Using a minimally invasive arthroscopic procedure the surgeon can visualize the meniscus and further define the type, location, and extent of the tear. As the meniscus helps protect the knee from arthritis, the goal of the surgeon is to always repair the meniscus when possible. If the meniscus is repairable, a small suture will be placed. Depending on the type of tear and if repair is not possible, a portion of the meniscus that is torn and causing symptoms may be removed, called a meniscectomy.
After the surgery: Most patients are discharged the same day after this procedure. If meniscal repair was possible then the patient is placed in a knee brace for 6 weeks and will begin a gradual return to activity. After a meniscectomy patient will work with an expert physical therapist to gradually return to activity without a knee brace.
The knee contains four main ligaments that work together to provide stability. There are two cruciate ligaments inside the knee joint and two collateral ligaments on the sides. Depending on the injury, more than one of these ligaments can get torn at once and can lead to overall instability within the knee.
Depending on the injury, a surgeon may recommend a trial of 6 weeks of conservative management to let one of the ligaments heal before proceeding with surgery, or they may recommend a surgical procedure that reconstructs all torn ligaments at once. Multiligament knee reconstructions are standard knee procedures that can be performed with minimal incision and low complication rates.
Depending on the type of tear, debridement or replacement may be recommended. Common procedures involve the Matrix-associated autologous chondrocyte implantation (MACI) or others. Dr. Ephraim Dickinson and the team at Urgently Ortho are here to discuss the best option on an individual basis.
Using a minimally invasive arthroscopic procedure the surgeon can visualize the meniscus and further define the type, location, and extent of the tear. As the meniscus helps protect the knee from arthritis, the goal of the surgeon is to always repair the meniscus when possible. If the meniscus is repairable, a small suture will be placed. Depending on the type of tear and if repair is not possible, a portion of the meniscus that is torn and causing symptoms may be removed, called a meniscectomy.
After the surgery: Most patients are discharged the same day after this procedure. If meniscal repair was possible then the patient is placed in a knee brace for 6 weeks and will begin a gradual return to activity. After a meniscectomy patient will work with an expert physical therapist to gradually return to activity without a knee brace.
Why Choose Us?
Pacific Crest Orthopedics offers a complete spectrum of orthopedic care in San Francisco. Whether you’re experiencing a sudden injury or managing a chronic condition, we’re here to get you back on track quickly.
Immediate Access
Get quick access to our orthopedic specialists with same-day and walk-in appointments.
Comprehensive Care
From the common to the complex, every patient receives top-tier orthopedic care from orthopedic experts.
Minimally Invasive Surgery
Should conservative measures fail, we offer advanced, minimally invasive surgical techniques to reduce recovery time & improve outcomes.
Elbow Surgery
Dr. Ephraim Dickinson specializes in many other surgical procedures of the elbow including: lateral ligament reconstruction, olecranon spur & bursae debridement
The biceps is a powerful muscle in the anterior portion of the arm that allows flexion and rotation of the forearm. It is useful in lifting objects and during activities of daily living. Repetitive lifting can cause tendinitis of the biceps that can be treated conservatively. More acutely, the biceps tendon can partially or fully tear, causing a popping sound, deformity and pain. An MRI is typically ordered to confirm diagnosis of a biceps tendon tear. Depending on age and activity level this can be treated conservatively or surgically.
A surgical distal biceps repair typically involves making a small incision in the forearm, grabbing the retracted and torn tendon, and anchoring it down to the bone with stitches. Afterwards, the patient is placed in an elbow ROM brace and is able to gradually return to activity over the course of 3 months with the help of physical therapy.
After The Surgery : Shoulder arthroscopy is a standard procedure with a low complication rate. Shoulder arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a sling.
Lateral epicondyle debridement or repair serves as a vital intervention for addressing issues like lateral epicondylitis, a common overuse injury affecting the tendons around the lateral epicondyle of the elbow. This condition often arises from repetitive motions, such as those encountered in sports like tennis or occupations involving manual labor. Orthopedic surgeons employ precise techniques to debride or repair the damaged tissue, aiming to alleviate pain, restore functionality, and prevent further degeneration of the affected area. Through careful assessment and personalized treatment plans, orthopedic surgeons tailor their approach to each patient’s unique needs, promoting optimal outcomes and facilitating a return to activity and quality of life.
Orthopedic surgeons utilize advanced surgical tools and methods to perform lateral epicondyle debridement or repair with precision and efficacy. These procedures may involve arthroscopic techniques, where small incisions are made, and specialized instruments are inserted to visualize and treat the affected area minimally invasively. Alternatively, open surgery may be necessary for more extensive repairs or cases where arthroscopy is not feasible. With a focus on restoring biomechanical integrity and function to the elbow joint, orthopedic surgeons play a crucial role in managing lateral epicondylitis and helping patients regain comfort and mobility in their daily activities.
Ulnar nerve transposition is a procedure often employed to relieve symptoms associated with ulnar nerve compression or entrapment. The ulnar nerve runs from the neck down to the hand, passing through several areas where it can become compressed, most commonly at the elbow, causing pain, tingling, weakness, and numbness in the hand and fingers. Orthopedic surgeons may recommend transposing or moving the ulnar nerve to a new position within the arm to alleviate pressure and restore normal nerve function. This procedure typically involves carefully relocating the nerve from its original position, often behind the medial epicondyle of the elbow, to a new location in front of it, thereby reducing the risk of compression and improving symptoms.
Ulnar nerve transposition in orthopedic surgery is a precise and delicate procedure that requires meticulous planning and execution to achieve optimal outcomes. Surgeons may utilize various techniques, including subcutaneous, submuscular, or intramuscular transposition, depending on factors such as the severity and location of nerve compression, as well as individual patient anatomy. By repositioning the ulnar nerve away from areas prone to compression, orthopedic surgeons aim to alleviate pain and dysfunction, allowing patients to regain sensation and strength in their hand and fingers. Postoperative rehabilitation and monitoring are crucial to ensure the success of the procedure and promote full recovery for patients experiencing ulnar nerve compression symptoms.
Hand & Wrist Surgery
Dr. Ephraim Dickinson specializes in many other surgical procedures of the hand & wrist including: Ganglion cyst removal and ulnar nerve transposition.
Carpal tunnel syndrome is a repetitive use injury that can occur when the median nerve gets compressed in the carpal tunnel. This can cause pain and numbness in multiple fingers in the hand. The team at Urgently Ortho will typically recommend bracing, activity modification, anti inflammatories and a corticosteroid injection. Many patients improve with these conservative measures; however, for those that have continued symptoms, a routine surgical procedure can be performed.
The surgery involves making a small incision in the wrist then releasing the carpal tunnel. This will stop compression of the median nerve and ideally prevent patients from feeling the continued numbness and pain in their fingers. This is a quick outpatient procedure that has patients back to their home within a few hours.
This is a routine surgery with a low complication rate. After surgery, patients are typically wrapped in a bandage for about a week then are gradually able return to their everyday activities.
Once a diagnosis is made, the surgeon can treat and repair the problem in the knee using various instruments through the arthroscopic ports. Repairs can include cartilage repair, meniscal repair or removal, removal of baker’s cyst, removal of loose fragment of bone, removal of medial plica, and aiding in reconstruction or repair of a torn cruciate ligament.
After the surgery: Knee arthroscopy is a standard procedure with a low complication rate. Knee arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a brace.
Trigger finger is a common condition that is caused by inflammation building up around the sheath of the tendon in the palm of the hand, called the A1 pulley. This can cause a locking sensation when a patient attempts to straighten their finger. This can be a frustrating condition that can affect daily activities. This condition is often treated conservatively with night splints, anti-inflammatories and corticosteroid injections.
If these conservative measures do not improve symptoms then a trigger finger release surgery is typically recommended. This surgery is a routine outpatient procedure that can be done under local or general anesthesia. A surgical release is done by making a small incision in the palm of the hand then cutting the inflammatory sheath in order to release the A1 pulley.
Patients typically have very good outcomes from this procedure and recover and return to all activities quite quickly.
The surgery involves making a small incision in the wrist then releasing the carpal tunnel. This will stop compression of the median nerve and ideally prevent patients from feeling the continued numbness and pain in their fingers. This is a quick outpatient procedure that has patients back to their home within a few hours.
This is a routine surgery with a low complication rate. After surgery, patients are typically wrapped in a bandage for about a week then are gradually able return to their everyday activities.
Once a diagnosis is made, the surgeon can treat and repair the problem in the knee using various instruments through the arthroscopic ports. Repairs can include cartilage repair, meniscal repair or removal, removal of baker’s cyst, removal of loose fragment of bone, removal of medial plica, and aiding in reconstruction or repair of a torn cruciate ligament.
After the surgery: Knee arthroscopy is a standard procedure with a low complication rate. Knee arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a brace.
De Quervain’s tendinosis is a condition that causes pain at the level of the wrist on the thumb side due to inflammation of the tendons. The pain can travel from the thumb up the forearm and may make some activities more difficult, especially with bending the wrist or attempting to make a fist. This is a repetitive use injury that can occur to anyone but is especially prevalent in new moms.
If conservative measures fail, then a careful procedure called a surgical release can be done to release the tendons on the wrist near the thumb. It is a delicate procedure that involves making a small incision then releasing the soft tissue which allows the tendon to be freely mobile to decrease symptoms.
After surgery, patients are typically wrapped in a bandage for 1-2 weeks then gradually return to activities of daily living with the help of a physical therapist over the next 4-6 weeks.
If these conservative measures do not improve symptoms then a trigger finger release surgery is typically recommended. This surgery is a routine outpatient procedure that can be done under local or general anesthesia. A surgical release is done by making a small incision in the palm of the hand then cutting the inflammatory sheath in order to release the A1 pulley.
Patients typically have very good outcomes from this procedure and recover and return to all activities quite quickly.
The surgery involves making a small incision in the wrist then releasing the carpal tunnel. This will stop compression of the median nerve and ideally prevent patients from feeling the continued numbness and pain in their fingers. This is a quick outpatient procedure that has patients back to their home within a few hours.
This is a routine surgery with a low complication rate. After surgery, patients are typically wrapped in a bandage for about a week then are gradually able return to their everyday activities.
Once a diagnosis is made, the surgeon can treat and repair the problem in the knee using various instruments through the arthroscopic ports. Repairs can include cartilage repair, meniscal repair or removal, removal of baker’s cyst, removal of loose fragment of bone, removal of medial plica, and aiding in reconstruction or repair of a torn cruciate ligament.
After the surgery: Knee arthroscopy is a standard procedure with a low complication rate. Knee arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a brace.
Ankle & Foot Surgery
At Urgently Ortho we customize a treatment plan to meet your individual needs. For the foot and ankle, some of the most common treatments can include immobilization in a walking boot or cast, corticosteroid injections, the use of anti-inflammatories, and physical therapy. For some conditions, surgery is indicated as the best option.
Dr. Ephraim Dickinson performs manipulation under anesthesia of the ankle if needed.
The Achilles tendon is a band of fibrous tissue that connects the calf muscle to the calcaneus and is paramount in flexion and extension of the ankle. The Achilles tendon can partially or fully tear in high impact and heavy loading sports injuries. Depending on the type of tear and activity level of the patient, these injuries can be treated with either conservative or surgical management.
If surgical management is chosen it is typically an outpatient procedure. This procedure involves making an incision in the back of the ankle then carefully suturing the ends of the tendon together.
Recovery for this procedure is a 3-6 month process involving non-weightbearing in a cast for around 6 weeks. This is followed by a gradual return to weightbearing in an elevated walking boot followed by extensive physical therapy. We recommend speaking to your orthopedic team to discuss if surgical repair versus nonsurgical protocol is better for you.
A surgical distal biceps repair typically involves making a small incision in the forearm, grabbing the retracted and torn tendon, and anchoring it down to the bone with stitches. Afterwards, the patient is placed in an elbow ROM brace and is able to gradually return to activity over the course of 3 months with the help of physical therapy.
After The Surgery : Shoulder arthroscopy is a standard procedure with a low complication rate. Shoulder arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a sling.
The tibia and fibula are two of the bones that come together to comprise the ankle joint. At the ankle joint these bones are called the lateral and medial malleolus. They can easily get fractured in common inversion injuries. Depending on the type of fracture, these injuries can make the ankle joint unstable and can occasionally require surgical fixation to prevent instability of the ankle and help patients return to full activity.
Most of these procedures are open surgeries that require making an incision near the fracture and then placing a plate and screws over the fracture to promote healing.
Afterwards, patients are typically immobilized in a cast for 4-6 weeks then are gradually able to return to weightbearing and activities.
If surgical management is chosen it is typically an outpatient procedure. This procedure involves making an incision in the back of the ankle then carefully suturing the ends of the tendon together.
Recovery for this procedure is a 3-6 month process involving non-weightbearing in a cast for around 6 weeks. This is followed by a gradual return to weightbearing in an elevated walking boot followed by extensive physical therapy. We recommend speaking to your orthopedic team to discuss if surgical repair versus nonsurgical protocol is better for you.
A surgical distal biceps repair typically involves making a small incision in the forearm, grabbing the retracted and torn tendon, and anchoring it down to the bone with stitches. Afterwards, the patient is placed in an elbow ROM brace and is able to gradually return to activity over the course of 3 months with the help of physical therapy.
After The Surgery : Shoulder arthroscopy is a standard procedure with a low complication rate. Shoulder arthroscopies are typically classified as outpatient procedures, and patients return to their home the same day. Recovery depends on the type of repair that was done, but may involve pain medications, physical therapy, or a sling.
Trauma / Fracture Care
A fracture is a type of medical condition that occurs when someone falls or stresses a bone so much that it causes the bone to break. These can happen to any age group and can be treated in many different ways depending on the type of fracture and location. Simple fractures that cause no displacement of the bone can often be treated conservatively, often with immobilization.
Although many fractures of the extremities can be treated conservatively, depending on the fracture pattern, the orthopedist may recommend surgery for overall stability and optimal healing of the bone. Surgery is recommended in fractures with poor alignment, instability, or fractures that may cause early osteoarthritis or decreased range of motion in the future. Surgical fixation typically needs to be completed within 7-14 days of the initial fracture.
Depending on the type of fracture and bone that was broken, open reduction internal fixation (ORIF), aka surgical fixation, typically involves placing a plate and screws, intramedullary nailing, or Kischner wires to realign the bones. With and without surgery, fractures can take 6 weeks to 3 months to fully heal. After any cast is removed they will diligently work with a physical therapist to regain strength and motion and ultimately return to all activities.
Procedures:
- ORIF clavicle (proximal / midshaft / distal)
- ORIF proximal humerus
- ORIF greater tuberosity fracture
- ORIF humeral shaft
- ORIF olecranon
- ORIF radial head fracture
- ORIF distal radius fracture
- ORIF both bone forearm fractures
- ORIF patellar fractures
- ORIF tibial plateau fractures
- ORIF bimalleolar ankle fractures
- ORIF trimalleolar ankle fractures
- ORIF distal fibular fractures
- ORIF metatarsal fracture (Jones fractures)
- Syndesmotic fixation
Arthroplasty / Joint Surgery
At Urgently Ortho we customize a treatment plan to meet your individual needs. For osteoarthritis some of the most common treatments can include different types of injections, the use of anti-inflammatories, physical therapy, and bracing. For some conditions, surgery in the form of joint replacement can be the best option.
When all other methods of treatment for arthritis have failed, joint replacement is recommended. A total, or complete, knee replacement is when all the arthritic surfaces of the joint are surgically removed and replaced with a metal surface and a plastic spacer. This procedure is highly effective and is still the recommended treatment for advanced arthritis of the knee. The surgery takes 1-2 hours. Full weight bearing is allowed as tolerated the day after surgery. Full recovery takes 3-6 months. The average knee replacement can be expected to last 10-15 years.
Partial Knee Replacement: (Unicondylar Replacement) Our approach to treatment of knee arthritis is to preserve the knee whenever possible rather than replace it. For many patients, we can avoid replacement altogether by replacing cartilage, realigning the leg, injecting stem cells or other advanced biologic options. For those patients who are no longer candidates for biologic preservation of the knee, some doctors automatically recommend a full knee replacement. However, newer techniques of replacement allow us to preserve much of the knee and only replace the injured areas. This is called a partial knee replacement. Often only one part of the knee has arthritis. So why remove the entire knee? Partial knee replacements take approximately 1 hour, and the patient can go home the same day and put weight on the knee immediately. Success rates are greater than 90% and provide a more stable and natural feeling knee than a full knee replacement.
When other treatments for chronic shoulder pain fail, total shoulder replacement is often recommended. This procedure involves replacing the damaged joint surfaces with a metal ball and a plastic socket. It is highly effective in relieving pain and restoring function for advanced shoulder arthritis. The surgery typically takes about 2 hours, and most patients can begin gentle movements soon after. Full recovery usually spans 3-6 months, during which time physical therapy is crucial. A total shoulder replacement can significantly improve the quality of life and typically lasts 10-15 years.
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