AdventHealth Medical Group Orthopedics and Spine at Inverness

A total hip replacement using the minimally invasive direct anterior approach is an alternative to a conventional hip replacement. Hip replacements are historically performed using posterior (back) or lateral approaches, which require making incisions into certain muscles or tendons to access the hip joint.

The direct anterior approach utilizes a muscle in front of the hip joint and doesn’t require muscles and tendons to be opened to access the joint.

Patients who have undergone a hip replacement using the anterior approach typically experience less postoperative pain and discomfort and faster recoveries. Most patients are discharged from the hospital after two days and no longer need walking aids like a cane or crutches within two weeks of surgery.

The anterior approach is not recommended for all patients. Most patients undergoing a hip arthroplasty revision benefit more from traditional methods. Patients who have hip deformities from childhood also, on occasion, are not candidates for the direct anterior approach.

The advanced anatomic repair technique for rotator cuff and labral tendon repairs utilizes multiple row or footprint attachments for tendons instead of the standard single row, allowing the surgeon to mimic anatomic tendon positioning better. This technique enables the surgeon to inspect the integrity of the shoulder anatomy better.

Lumbar Artificial Disk Replacements

Lumbar artificial disk replacement is a surgical method of replacing diseased or damaged intervertebral disks with artificial disks to restore motion to the spine. It’s an alternative to spinal fusion for patients with lower back pain. It’s also an option for patients with degenerative disk disease, a gradual degeneration of the disks between the vertebrae caused by aging.

Your doctor may recommend diagnostic tests like magnetic resonance imaging (MRI), discography, computed tomography (CT scan) or X-rays to identify the cause of your pain. Patients with back pain caused by bulged or worn-out intervertebral disks and patients with no significant facet joint disease are candidates for artificial disk replacement. The surgery is not recommended for patients with scoliosis, previous spinal surgery or who are morbidly obese.

During surgery, an incision is made in the abdomen, and the muscles and the blood vessels are gently moved for a better view and room for surgery. The disk space is opened, the damaged disk is removed and replaced with the artificial disk.

Disk Design

There are two types of artificial disk designs: disk nucleus replacement and total disk replacement.

With the disk nucleus replacement, only the central portion of the disk (nucleus) is removed and replaced with a mechanical device, while the outer ring of the disk is left intact. However, the disk nucleus replacement procedure is not commonly practiced and is still in the investigative stage.

In total disk replacement, the annulus and nucleus are both replaced with a mechanical device. Artificial disks are usually made up of metal, plastic or a combination of medical-grade plastic and medical-grade cobalt chromium or titanium alloy.

Rehabilitation can begin soon after the surgery. A hospital stay of about two to four days may be required. Basic exercises, including walking and stretching, may be performed during the first few weeks after surgery.

Artificial disk replacement surgery may cause certain complications, including:

• Infection
• Injury to blood vessels
• Dislodgement or breakage of the device
• Wear of the device materials
• Continued or increasing pain
• Bleeding
• Bladder problems

Carpal tunnel syndrome is a common condition and can be treated with minimally invasive endoscopic surgery, which involves only a few half-inch incisions and the use of an endoscope.

In endoscopic surgery, a thin, flexible tube with a camera (endoscope) is inserted into small incisions in the wrist and hand. The endoscope helps your surgeon visualize the internal structures at the wrist, avoiding the need for a large incision. Patients are usually discharged home the same day.

Your surgeon will suggest certain postoperative care for a better recovery and to avoid complications, including:

• Elevating the hand above heart level to reduce swelling
• Wearing a splint
• Ice packs to reduce swelling
• Keeping the incision clean and dry
• Physical therapy may be ordered to restore wrist strength
• Eating a healthy diet and not smoking will promote healing

Most patients do not have any complications following carpal tunnel release surgery. If complications do arise, like continued pain or infection, we will work with you to manage your symptoms effectively.

Hip Resurfacing

Hip resurfacing, or bone conserving, replaces the acetabulum (hip socket) and resurfaces the femoral head. This means the femoral head has some or very little bone removed and replaced with the metal component. This spares the femoral canal.

Revision Hip Replacement

This option is for patients with previous hip replacements that need to be revised. This procedure varies from minor adjustments to complex procedures that replace significant amounts of bone material.

Hip Arthroscopy

Hip arthroscopy is a relatively new surgical technique that is effective for a variety of hip conditions.

Femoroacetabular Impingement (FAI)

FAI results from abnormal pressure and friction between the hip joint's ball and socket, resulting in pain and progressive hip dysfunction. When left untreated, it leads to secondary osteoarthritis of the hip.

Knee Arthroscopy

The benefits of arthroscopy include smaller incisions, faster healing and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis.

Total Knee Replacement (TKR)

A total knee replacement (TKR) or total knee arthroplasty resurfaces an arthritic knee joint with artificial metal or plastic replacement parts called prostheses.

Anterior Cruciate Ligament (ACL) Reconstruction

The ACL is a strong rope-like structure running from the femur to the tibia and is a major stabilizing ligament in the knee. When this ligament tears, it doesn't heal and often leads to instability in the knee.

ACL reconstruction is a common surgical procedure, and with recent advances, it can now be performed with minimal incisions and fewer complications.

Unicondylar Knee Replacement

In this procedure, only part of the knee joint is replaced, using a smaller incision than would be used for a total knee replacement.

The knee joint is made up of the patellofemoral, medial and lateral compartments between the femur and tibia. Often, only one of these compartments wears out, typically the medial one. If your symptoms and X-ray findings indicate this, you may be a candidate for this procedure.

Revision Knee Replacement

This means that part or all of your previous knee replacement needs to be revised. This operation varies from minor adjustments to complex operations that replace significant amounts of bone.

Rotator Cuff Tear

The rotator cuff is the group of tendons in the shoulder that provide support and enable a wider range of motion. Major injury to these tendons may result in the tearing of these tendons, called a rotator cuff tear.

Shoulder Impingement

Also called swimmer’s shoulder, tennis shoulder or rotator cuff tendinitis, shoulder impingement is inflammation of the tendons of the shoulder joint. It can be caused by car accidents, trauma or sports like tennis, baseball, swimming and weightlifting.

Shoulder Arthroscopy

Shoulder arthroscopy is a minimally invasive surgical procedure. The benefits are smaller incisions, faster healing and less scarring. Arthroscopic surgical procedures are often outpatient surgeries, and the patient can return home on the same day.

Frozen Shoulder

Frozen shoulder is when pain and inflammation in the shoulder severely restrict movement. It’s also called adhesive capsulitis and may progress to the state where it’s very difficult to move the shoulder at all.

Shoulder Joint Replacement

Shoulder joint replacements are usually done to relieve pain and when all non-operative treatments to relieve pain haven’t been effective.

Treatment options for normal spine anatomy and spinal deformities include:

• Spinal fusion
• Lumbar diskectomy
• Lumbar laminectomy

We treat a variety of elbow ailments, including:

• Elbow fracture
• Elbow sprain
• Golfer’s elbow
• Tennis elbow
• Other issues or injuries to the normal anatomy of the elbow

We treat many common hand-related health conditions and offer state-of-the-art care for hands and wrists.

Trigger Finger

The tendons of the thumb and each of the fingers pass through a sheath on the palm side of the hand. Certain diseases and overuse activities can cause it to thicken. Eventually, the tendon becomes irritated and swells. Pain, catching and locking of the finger will occur. Early treatment consists of anti-inflammatory medication or cortisone injections. If these don’t provide relief, minimally invasive surgery is recommended.

Dupuytren's Contracture

This disorder is an abnormal thickening of tissues in the palm, resulting in nodules on the ligament, which, if severe enough, can cause an inability to straighten the fingers fully. No surgery is needed if the condition is mild and there is no functional loss. But if it interferes with the full use of the hand, surgery can improve function and prevent further deformity.

De Quervain's Tenosynovitis

Tendonitis around the thumb can be painful and disabling, making simple pinching and twisting almost impossible. Treatment consists of rest, medication and occasionally the use of a steroid injection. If these treatments do not provide relief over time, the tendons can be surgically released.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common problem resulting from pressure on the median nerve at the wrist. Symptoms, often worse at night, consist of numbness and pain in the wrist and fingers. Eventually, there is a loss of strength, fine motor control and sensation.

Early treatment consists of splinting and anti-inflammatory medication. If symptoms do not improve, an outpatient surgical procedure to relieve the pressure on the nerve is suggested.

While many fractures result from high-force impact or stress, bone fractures can also occur due to certain medical conditions that weaken the bones, such as osteoporosis.

We treat bone fractures in multiple areas of the body:

Foot and Ankle

• Ankle fractures
• Heel fractures
• Lisfranc (midfoot) fracture
• Stress fractures of the foot and ankle
• Talus fractures
• Toe and forefoot fractures

Hip

• Hip and pelvis fractures

Knee and Leg

• Fractures of the proximal tibia
• Pediatric thighbone fracture
• Shinbone fractures
• Thighbone fracture

Shoulder, Arm and Elbow

• Broken arm
• Broken collarbone
• Elbow fractures
• Fracture of the shoulder blade
• Pediatric elbow and forearm fractures
• Radial head fractures
• Shoulder trauma