Conditions & Procedures

Osteoarthritis is the progressive loss of joint cartilage in the hip or knee, causing pain, stiffness, reduced mobility, and in severe cases, deformity and bone damage. It is the most common indication for joint replacement surgery. Treatment depends on severity — from lifestyle modifications, oral therapy, gait aids, physical therapy, and injections, to surgical reconstruction when conservative measures no longer provide adequate relief.
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Post-traumatic osteoarthritis develops as a direct consequence of prior joint injury — most commonly a fracture involving the joint surface, a significant ligament rupture, or a dislocation. Even when such injuries are treated appropriately, the initial damage to cartilage and the altered joint mechanics that follow can set in motion a degenerative process that progresses over years or decades. Patients may develop worsening pain, stiffness, and mechanical symptoms long after the original injury has healed. When prior hardware is present, surgical planning must account for its removal, which may be performed at the same time as or staged before joint replacement.
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Rheumatoid, psoriatic, and other autoimmune arthritides cause the immune system to attack joint tissue, leading to chronic inflammation, cartilage destruction, and deformity. Medical management by a rheumatologist is central to care, however when joint damage becomes severe, surgical reconstruction restores function and relieves pain.
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Avascular necrosis (osteonecrosis) results from disrupted blood supply to the femoral head or knee, causing bone tissue to die and the joint surface to collapse. Risk factors include corticosteroid use, alcohol, and trauma. Advanced disease typically requires joint replacement; early-stage cases may be managed conservatively depending on extent of involvement.
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Periprosthetic fractures occur in bone surrounding an existing hip or knee implant, most often after a fall. These injuries require careful evaluation of implant stability and bone quality. Management may involve fracture fixation, implant revision, or both, depending on fracture pattern and integrity of the existing prosthesis.
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Prosthetic joint infection occurs when bacteria colonize an implant surface, forming a biofilm resistant to standard antibiotics. It is one of the most serious complications following joint replacement, yet thankfully it is rare. There are many treatment options depending on the severity of the infection, the microbe causing the infection, and the health of the patient, though most options involve surgical implant removal, targeted antibiotic therapy, and reimplantation — typically in coordination with infectious disease specialists.
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Orthopedic trauma encompasses fractures and musculoskeletal injuries of the upper and lower extremities. Management ranges from closed reduction and casting to surgical fixation with plates, rods, or screws. Fractures range widely in severity, and each requires a tailored treatment plan.
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The anterior approach accesses the hip from the front, working between natural muscle planes without detaching them. This tissue-sparing technique is associated with faster early recovery, reduced post-operative pain, and lower initial dislocation risk. It requires specialized positioning and advanced surgical training, and is well-suited to patients with appropriate anatomy and body habitus.

The posterior approach provides excellent exposure and is especially useful for normal or complex anatomy, revision cases, and patients where anterior approach access is limited. With modern posterior capsule repair techniques, dislocation rates are comparable to the anterior approach. It remains the most widely performed approach to total hip replacement worldwide, with excellent outcomes.

Revision hip replacement involves removing and replacing a failed implant due to loosening, instability, wear, fracture, or infection. These cases are significantly more complex than primary surgery, requiring specialized implant systems, bone loss management, and soft tissue reconstruction. Outcomes depend on the underlying cause of failure.

Total knee replacement resurfaces all three compartments of the knee with metal and medical grade plastic implants. Robotic-assisted techniques allow for precise bone preparation and real-time soft tissue balancing, resulting in more consistent implant positioning. Both robotic and manual methods have excellent outcomes — technique selection is based on anatomy, deformity, and clinical presentation.

Partial knee replacement resurfaces only the damaged compartment, preserving healthy cartilage, ligaments, and bone. This bone-conserving approach offers a more natural feel and faster recovery, in appropriately selected patients. Not all patients are candidates for this procedure. Robotic assistance provides the precision required for optimal implant placement in the smaller operative field.

Revision knee replacement addresses a failed primary implant due to loosening, instability, stiffness, wear, fracture, or infection. Specialized revision components provide additional fixation and structural support in compromised bone. Robotic-assisted techniques can optimize alignment in select revision cases with altered bony anatomy.

Conversion arthroplasty is joint replacement performed in a hip or knee that has previously undergone fracture fixation — most commonly converting a prior hip fracture repair (dynamic hip screw, cephalomedullary nail, or cannulated screws) or knee fracture fixation to a total joint replacement. Over time, prior fixation hardware can fail due to progressive arthritis, hardware loosening or breakage, avascular necrosis, or malunion — leaving the patient with a painful, dysfunctional joint that requires reconstruction.

These cases require removal of the existing implants before or during joint replacement. Depending on the complexity of hardware removal and the condition of the surrounding bone, this may be accomplished in a single combined surgery or as two staged procedures — first removing the prior hardware to allow bone recovery, then performing the joint replacement. Conversion arthroplasty carries higher surgical complexity than primary joint replacement and requires experience with both fracture surgery and arthroplasty.
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Minimally invasive approaches limit incision size and reduce disruption to surrounding muscles and soft tissues during joint replacement. Benefits include less post-operative pain, reduced blood loss, shorter hospital stays, and faster return to function. Appropriate candidacy is based on anatomy, body habitus, and the complexity of the reconstruction.

Most Prosthetic Joint Infections are managed surgically, with only select cases treated with life-long suppressive antibiotics. Surgical management typically includes implant removal with a possibility of an antibiotic spacer placement, followed by targeted antibiotic therapy, then reimplantation of new implants once infection is eradicated. In select cases, single-stage exchange or irrigation and debridement with implant retention may be appropriate based on the patient's overall health, infecting organism's virulence, duration of infection, and the quality of local muscles, tendons, ligaments, and bones.

Limb salvage surgery encompasses complex reconstructive procedures for severely damaged hip and knee joints when standard options are insufficient. Cases may involve extensive bone loss, failed prior reconstructions, or post-tumor defects. Custom or mega-prosthetic implants, structural bone grafting, and careful soft tissue management are frequently required.

Fracture management ranges from closed reduction and casting to open reduction and internal fixation (ORIF) with plates, screws, or intramedullary nails for complex injuries. Surgical decisions are guided by fracture pattern, displacement, soft tissue status, bone quality, and patient functional demands.