Services | hillorthoorlando

Joint Replacement

Severe joint pain is the most common reason patients undergo a joint replacement procedure. Whether your pain is from of an old injury, such as a fracture, or from a degenerative condition like rheumatoid arthritis or osteoarthritis, joint replacement procedures may be for you. Almost every joint in the body can be replaced with a fully functioning artificial implant, but the
most common joint replacements are of the hip, knee, or shoulder.

You may be a candidate for a joint replacement surgery if you are experiencing any of the
following symptoms:

Severe joint pain
Joint deformity
Pain in the joint that keeps you awake at night
Joint discomfort that prevents you from participating in recreational activities
Joint pain that limits your ability to conduct necessary and daily functions, such as climbing stairs or standing up
You have attempted more conservative treatment methods, such as exercise or therapy, without
success
Hip arthritis http://orthoinfo.aaos.org/topic.cfm?topic=A00213
Hip Avascular necrosis http://orthoinfo.aaos.org/topic.cfm?topic=A00213
Total Hip Replacement http://orthoinfo.aaos.org/topic.cfm?topic=A00377
Hip Implants:http://orthoinfo.aaos.org/topic.cfm?topic=A00355, www.zimmer.com
Knee Arthritis http://orthoinfo.aaos.org/topic.cfm?topic=A00212
Total Knee Replacement http://orthoinfo.aaos.org/topic.cfm?topic=A00389
Unicompartmental replacement http://orthoinfo.aaos.org/topic.cfm?topic=A00585
Knee implants http://orthoinfo.aaos.org/topic.cfm?topic=A00221, www.zimmer.com

Call us at Hill Orthopedic Center for more information

Foot and ankle conditions

Dr Hill Has completed a fellowship training in foot and ankle surgery at the University of South Alabama under the direction of Arthur Manoli, MD.

At Hill Orthopedic center we treat both traumatic and nontraumatic conditions of the foot and ankle

Some of the more common conditions may include:

Ankle and foot traumatic injuries
Tendonitis and tendon tears
Ligament sprains and tears
Achilles’ tendon pain
Plantar fasciitis
Bunions, hammertoes, clawtoes
Ankle and foot arthritis
Flat foot and other foot and ankle deformities

Many problems in the foot and ankle can be treated successfully without surgery, however if surgery is needed, we provide cutting-edge surgical techniques to eliminate pain and restore function. Typically these can be performed in the outpatient setting.

Call us at Hill Orthopedic Center at 4074477001 for more information

Knee, Shoulder, and Ankle Arthroscopy

Arthroscopy is a form of surgery that allows us to gain a visual of the problems that are actually causing your pain. Using a tool known as an arthroscope, we are able to actually see the problems that exist within these joints. The arthroscope is a fiber optic instrument narrower than a pen, which can be put into a joint through small incisions less than 5 millimeters in length. A camera is attached to the arthroscope and the image is viewed on an LCD computer monitor. Small instruments ranging from 3-5 millimeters in size can be inserted through small incisions. These instruments allow the surgeon to see the various joint
structures,to diagnose the injury and then to repair, reconstruct or remove the damaged structure. To help your surgeon view the joint, sterile fluid is pumped into the joint.

The benefits of arthroscopy involve smaller incisions, faster healing, a more rapid recovery, and less
scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.

Nonsurgical treatments

Cortisone Shots

Your body naturally makes its own cortisone when your body is under stress this is called cortisol. It is a type of steroid that is produced naturally by your adrenal gland and is released when your body is under stress.

Injectable cortisone is synthetically produced but is very similar to that produced by your body.
The injectable cortisone is injected into the affected area or joint.The injectable cortisone is typically long
acting over several weeks or months. Cortisone is a strong anti-inflammatory medication. Cortisone only treats the nflammation. When pain is decreased from cortisone it is because the inflammation is
decreased. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side-effects to a minimum. Cortisone injections
usually start to work within 2 days to a week, and the effects can last for up to several months. Many times once the inflammation is gone, the pain will stay away.

Many conditions where inflammation is an underlying problem are amenable to cortisone shots.
These include, but are certainly not limited to:

Shoulder Impingement
Partial rotator cuff tear
Calcific tendonitis
Arthritis of the shoulder, hip, knee or spine
Tennis or golfers elbow
Bursitis of the knee or hip
Plantar fascitis
Trigger points
Trigger finger
Carpal tunnel
Back pain, neck pain

The shot can be slightly painful, especially when given into a joint, but is usually well tolerated. Also,
topical anesthetics can help numb the skin in an area being injected. The most common side-effect is a ‘cortisone flare,’ a condition where the injected cortisone crystallizes and can cause a brief period of pain worse than before the shot. It usually lasts a day or two and is best treated by icing the injected area and taking an oral anti- inflammatory. . Another common side-effect is whitening of the skin where the
injection is given. This is only a concern in people with darker skin, and is not harmful, but patients should be aware of this. Some patients will have flushing of the face that can last for hours to a couple of days and then will resolve. The most concerning risk of an injection, is infection, especially if the injection is given into a joint. The best prevention is careful injection technique, with sterilization of the skin using
iodine and/or alcohol. Also, patients with diabetes may have a transient increase in their blood sugar which they should watch for closely.

Platelet Rich Plasma Injections

Link: http://orthoinfo.aaos.org/topic.cfm?topic=A00648

Platelet-rich plasma or PRP is an “autologous blood therapy” that uses a patient’s own blood components to stimulate a healing response in damaged tissues.

In response to an injury or tissue damage, your body naturally recruits platelets and white blood cells from the blood to initiate a healing response. By enhancing the body’s natural healing capacity, the
treatment may lead to a more rapid, more efficient, and may lead to a more thorough restoration of the tissue to a more improved state

Knee Pain

Patellar tendonitis/tendinosis
Quadriceps muscle injuries
Ligament sprains or tears
Bursitis

Hip Pain

Pyriformis syndrome
Greater trochanteric Bursitis
Ischial bursitis
Hamstring tendonitis or tears

Shoulder and Arm Pain

Rotator Cuff tendonitis, tendinopathy or partial tears
Acromio-clavicular joint pain or arthritis
Bicipital tendonitis
Medial and Lateral epicondylitis (golfers & tennis elbow)
Ulnar Collateral Ligament sprain or tear

Lower Leg and Foot

Plantar Fasciitis
Shin Splints
Peroneal tendonitis
Ankle sprains
Achilles tendonitis or partial tears

Treatment plan:

Depending on the severity and duration of your injury, one to three PRP injections are suggested.

Following the initial treatment with PRP, a follow up visit occurs 2-3 weeks later. In general, chronic injuries require more than one injection. In both acute and chronic injuries, injections may be combined with an
exercise or physical therapy program to enhance the success of the treatment

Hyaluronic Acid injections™

Link: http://orthoinfo.aaos.org/topic.cfm?topic=A00217

Another way to treat your osteoarthritis (OA) knee pain right at the source. Hyaluronic acid is normally found within the synovial fluid in your joint. It is a thick viscous solution that lubricates and cushions the joint the injections are basically to help replenish the supply of hyaluran within the joint that decreases with the further advancement of arthritis. It can provide up to six months of knee pain relief. It is often used to help patients postpone total joint replacement

The side effects most commonly seen in a medical study were knee pain, stiffness and swelling or fluid buildup in or around the knee. Other side effects, such as rash, may also occur. Side effects were generally mild to moderate and did not last long.

Cervical and Lumbar Facet injections, Epidural steroids
http://orthoinfo.aaos.org/topic.cfm?topic=A00560

Facet injections and epidural steroid injections are a key component to nonsurgical pain management for chronic neck and back pain. The results may last anywhere from a week to more than a year. The
injections are often used in conjunction with other nonsurgical treatments such as therapy and medication. The injections are performed with fluoroscopic guidance to localize accurately the placement of the
needle. Local anesthesia is used prior to the injection. The injected material is a mixture of cortisone and anesthetic. Some side affects include increased pain, headaches, rash, short term increase in blood sugar.

Spinal cord stimulator
Link:http://www.bostonscientific.com/en-US/products/spinal-cord-stimulator-systems.html(also put this in the Resources section)

Spinal cord stimulators deliver electrical pulses from an implantable pulse generator to leads with
stimulating contacts in order to mask pain signals traveling to the brain.

The procedure is performed using fluoroscopic guidance. It takes about 30 minutes. The leads are

connected to an external system that the patient uses for a week to determine if there is pain is relieved and the leads are removed. If there has been relief in the patients pain, a small surgical procedure will be used to implant the stimulator permanently.

Kyphoplasty
Link:http://orthoinfo.aaos.org/topic.cfm?topic=A00538

This procedure is performed when the patient has sustained a compression fracture. This procedure is performed using fluoroscopic guidance. Local anesthetic is given. The trocar followed by the balloon is
introduced into the vertebrae. Once the compression is relieved, the cavity is filled with bone cement.

EMG/Nerve conduction studies
Link:: http://orthoinfo.aaos.org/topic.cfm?topic=A00270