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:

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.

Common shoulder problems treated with arthroscopy include:
AC Separation: Link:,
Shoulder Dislocation Link:
Rotator Cuff Tendonitis,Bursitis,&Impingement Syndrome
Rotator Cuff Tendon Tears Links:,,
Frozen Shoulder. Link: Frozen Shoulder. Link:
labral tears.
SLAP lesions.
Shoulder Arthritis Link:
Meniscus Injuries
ACL Ligament Injuries
Medial and Lateral Collateral Ligament Injuries, combined ligament injuries.
Knee Arthritis Link
Osteochondral lesions, loose bodies: Link:
Common Ankle Disorders treated arthroscopically include:
Ankle Sprains. Link:
Osteochondral lesions, loose bodies of the ankle

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

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™

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

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: 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.


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