TSAOG Named One of 2015’s 150 Great Places to Work in Healthcare

Posted on
Great Places to Work in Healthcare 2015 Logo from Becker's Hospital Review

We are very pleased to announce that The San Antonio Orthopaedic Group (TSAOG) and the Orthopaedic Surgery Center of San Antonio (OSCSA) were recently named by Becker’s Hospital Review as one of their 150 Great Places to Work in Healthcare: 2015.

According to Chris Kean, Chief Operations Officer for TSAOG, “It is a great honor for TSAOG and the Orthopaedic Surgery Center to be listed as one of Becker’s Great Places to Work in Healthcare. Our employees are the heart of our group and our company’s greatest asset, so we work every day to help them feel valued and appreciated at all levels of the organization.

Check out the full list from Becker’s Hospital Review

Striving to recruit and retain talented individuals is one more way TSAOG makes your health our mission.

TSAOG Seeks Participants for a Research Study of an Investigational Tissue Implant for Knee Cartilage Injuries (w/ VIDEO)

Posted on


***UPDATE: The NeoCart trial is no longer accepting participants.***

The San Antonio Orthopaedic Group (TSAOG) is participating in a research study evaluating an investigational treatment called NeoCart®, a tissue implant made from a patient’s own cells, aimed at repairing certain knee cartilage injuries. 

A total of 245 patients will participate in the research of the surgical procedure in up to 40 sites across the United States.
Orthopedic surgeon Brad S. Tolin, M.D. will be leading the clinical trial at The San Antonio Orthopaedic Group. Participating TSAOG surgeons include: 

The research study will look at damage to the knee’s hyaline articular cartilage, the smooth, white tissue that covers the ends of bones where they come together to form joints. Damage to this cartilage may be caused by an injury or repetitive motion. It is a common problem that results in pain and symptoms, such as swelling, locking of the knee and loss of knee function. Damaged hyaline cartilage has limited capacity to repair or restore itself.  Left untreated, the damage may progressively worsen and may lead to chronic conditions such as osteoarthritis.  

To perform the NeoCart® procedure, the surgeon first obtains a sample of healthy cartilage from the patient’s knee. The small sample is placed under special conditions in the laboratory that allow for cell growth.  These cells are used to form a hyaline-like cartilage tissue implant that is in the shape of a small disc.  The implant is then returned to the surgeon for surgical implantation into the patient’s’ injury site in the knee.  

According to Dr. Tolin, “Neocart potentially represents the exciting next generation of joint cartilage restoration. Knee cartilage injuries can be destructive to the joint surface, as cartilage has very little inherent capability to repair itself.  Longer term, this damage can eventually lead to degenerative arthritis. Biologic restoration of the articular cartilage joint surface can potentially avert the destructive progress of arthritis and the associated pain and functional disability.

Patients who are between 18 to 59 years old and who have symptoms of knee pain in one knee may be candidates for this study. However, those who have previously failed other treatments or smoke more than one pack of cigarettes per week may not be eligible.

Patients accepted into the study will have a two out of three chance of being treated with the NeoCart® implant and a one out of three chance of receiving the microfracture procedure, the current standard-of-care for this condition. Patients in each group will have a specific rehabilitation plan and will be evaluated regularly for three years after treatment.

The study sponsor is Histogenics Corporation.  For more information, visit, (keyword “NeoCart Phase 3”) or contact The NeoCart Contact Center at (830) 469-4546, text KNEE1 to 87888, or email [email protected].  

About NeoCart®
NeoCart®, a Phase 3 investigational product is an implant produced using a patient’s own cartilage cells.  A Phase 1 clinical trial conducted in the United States demonstrated favorable preliminary results, which supported proceeding to a Phase 2 clinical trial. A Phase 2 clinical trial conducted in the United States comparing NeoCart® to the standard-of-care microfracture met its endpoints for safety and for improvement in pain and function. These results support the continued clinical development of NeoCart®. The two-year results of the Phase 2 clinical trial are publicly available (Crawford et al. J Bone Joint Surg Am. 2012;94:979-89).  A Phase 3 clinical trial conducted in the United States comparing NeoCart® to the standard-of-care microfracture is currently in progress. Information about the study is available on and

Benefits of Outpatient Partial Knee Replacement

Posted on
~Video courtesy KSAT News and Aircheck Studios~

For the right patient – one with arthritis in only one area of the knee joint – partial knee replacement (or unicompartmental knee replacement) offers a less invasive alternative to total knee replacement that can help relieve pain and increase range of motion. Learn more about the difference between partial knee replacement and total knee replacement.

The San Antonio Orthopaedic Group (TSAOG) is now offering partial knee replacement as an outpatient procedure at our ambulatory surgery center. I sat down with board certified orthopedic surgeon Dr. Frank Garcia to discuss the benefits of outpatient partial knee replacement.

So why am I just hearing about this now?
Partial knee replacements have been around for many years, but certain developments in the healthcare landscape have made outpatient partial knee replacement possible relatively recently. These include advances in surgical technology and techniques, which have made the procedure less invasive, as well as the implementation of pre-surgical protocols including multimodal pain and anesthesia management, which has made the procedure less traumatic. Many centers throughout the country are now offering outpatient partial knee replacements with excellent results. 

Why would I want to have my partial knee replacement performed in an outpatient surgery center versus in the hospital?

There are several benefits to having this procedure performed on an outpatient basis versus in a hospital environment, but the big three are:

  • Safety
  • Patient Satisfaction
  • Cost

Talk about the safety aspect.
Safety is most people’s primary concern when considering any surgery. Procedures performed in an outpatient setting across the board tend toward lower rates of complications and infections than the same procedures performed in a hospital setting. Additionally, when you are dealing with an outpatient surgery center that caters to a specific specialty – like the Orthopaedic Surgery Center of San Antonio – you have even less chance of being exposed to certain infections than at a more generalized surgery center.

How is patient satisfaction impacted?
Recent studies indicate a higher Knee Society Clinical Rating System score and a higher patient satisfaction rate with same day or 23 hour stay outpatient partial knee  replacement versus standard hospitalized inpatient partial knee replacement.

What about cost? Is it less expensive to have a partial knee replacement done at an outpatient surgery center?
Yes, significantly. The rule of thumb is that the cost of an outpatient partial knee replacement is about 25% of the cost of an inpatient partial knee replacement. The direct cost to the patient will depend on individual insurance coverage, but patients can generally expect a savings of 30-50%.

Will my insurance cover outpatient partial knee replacement?
Yes. Most insurances cover partial knee replacements done on an outpatient basis. In fact, there is a growing trend of insurance companies supporting these procedures due to their lower complication rates and significant cost containment. Medicare took the lead on allowing outpatient partial knee replacement many years ago and has recently questioned the full admission of a patient for this procedure. Although it can still be done in the hospital, the recommendation has been for an outpatient admission rather than a full inpatient admission status for eligible patients. 

I’ve got knee pain. How do I find out if I’m a candidate?
Knee pain alone is not a reason to consider any kind of joint replacement. However, if your knee pain due to osteoarthritis is significantly affecting your daily life, it may be time to talk to your physician to see if you are a candidate for partial knee replacement.

Dr. Frank Garcia is a board certified orthopedic surgeon specializing in partial knee replacement and total knee replacement. He treats patients aged 14 years and up for all orthopedic conditions. To schedule an appointment with Dr. Garcia, please call 210.281.9595.


Stem Cell Therapy in Sports Medicine

Posted on

Orthopaedic surgeon and sports medicine specialist Dr. Christian Balldin was interviewed this week by WOAI Radio regarding the developing trend of using stem cell therapy to speed recovery from certain sports injuries. Check out the full interview:

Stem cell therapy in the field of orthopedics has been in the news a lot lately, with several high profile athletes – including Peyton Manning and Rafael Nadal – seeking the treatment out to boost their recoveries.

Mesenchymal stem cell therapy is now being offered by The San Antonio Orthopaedic Group. According to Dr. Balldin, “We are starting to apply it in a multitude of areas, including sports injuries, whether it be into actual joints, or to allow for a quicker recovery of ligament sprains and also for low back pain.” He says that stem cell therapy also can be “useful in recovery from common sports injuries, including rotator cuff injuries and tennis elbow.”

Learn more about orthopedic stem cell therapy at The San Antonio Orthopaedic Group.

broken bone doctor san antonioDr. Christian Balldin is a board certified orthopaedic surgeon, fellowship trained in sports medicine. He treats patients aged 3 years and up for any sports-related injury as well as conditions of the shoulder, hip, and knee. His special interests include complex knee reconstruction and shoulder arthroscopy. To schedule an appointment with Dr. Balldin, please call 210.281.9595.

Dr. Marvin Brown on Total Ankle Replacement (VIDEO)

Posted on
***Video Courtesy KSAT News and Aircheck Studios***

Dr. Marvin R. Brown, board certified orthopedic surgeon and foot & ankle specialist with The San Antonio Orthopaedic Group, was featured last night on KSAT News in a story about total ankle replacement.

He discusses the procedure for INBONE total ankle replacement along with ankle replacement patient Bettye Dube.

Ankle replacement is an option for patients with severe osteoarthritis of the ankle, which usually develops following injury to the ankle joint. If you have persistent ankle pain that is interfering with your daily life, the foot & ankle specialists at TSAOG can help. Not everyone will be a candidate for total ankle replacement, but there are a multitude of options available to alleviate joint pain

To learn more about total ankle replacement, visit our Ankle Replacement Webpage.

Dr. Marvin R. Brown is a board certified orthopedic surgeon, fellowship trained in conditions of the foot, ankle, & lower leg, with The San Antonio Orthopaedic Group. He treats patients of all ages and has a special interest in total ankle replacement and deformity correction. To schedule an appointment with Dr. Brown, please call 210.281.9595.

Dr. Alexander Rowland on Arthroscopic Treatment for Elbow Arthritis

Posted on
Elbow Pain Elbow Arthritis Elbow Arthroscopy

Osteoarthritis, a wearing down of the cartilage covering the ends of the bones, can develop in any joint of the body and the elbow is no exception. Elbow arthritis is generally characterized by loss of motion and pain in the elbow joint and tends to be more common in men who have had physically demanding jobs and/or have had elbow injuries in the past. 

Osteoarthritis often develops differently in the elbow than in the knee or hip because the elbow is a non-weight bearing joint. With less pressure on the elbow joint, the cartilage does not wear down as quickly as in weight bearing joints, but secondary problems can develop even when the cartilage is well-preserved.

  • Bone spurs (osteophytes) can develop around the periphery of the joint, limiting motion and causing pain with impingement.
  • Bone spurs can break off, becoming loose bodies within the joint and leading to symptoms of catching or locking.
  • Loose bodies within the elbow can further damage the joint over time, leading to progressive arthritis.

With severe osteoarthritis of the elbow, where the cartilage is significantly worn down, joint replacement (total elbow replacement) is an option for treatment. However, when the cartilage is well-preserved and pain and loss of motion is caused by the secondary problems described above, there is a better option for treatment: elbow arthroscopy.

Arthroscopic surgery of the elbow (or elbow scope) is a minimally invasive surgical technique which allows the surgeon to access, explore, and operate on the elbow joint through very small incisions. The use of an arthroscope (a small instrument containing a lens and fiber optic lighting system) connected to a camera allows the surgeon to see a magnified and enhanced view of the interior of the joint on a television screen, negating the need for a larger incision (open surgery).

Elbow arthroscopy is performed as an outpatient procedure and requires general anesthesia. Generally two to five 4mm incisions are made around the elbow for evaluation and treatment of the joint. Offending bone spurs are removed as well as any loose bodies. If a contracture of the joint is present, scarred tissue is resected to help regain lost motion. The entire procedure takes 60 – 90 minutes. Patients are discharged with a soft dressing and start physical therapy 2-3 days after the surgery. Complete recovery is expected in 6 to 8 weeks.

The main advantages of arthroscopic surgery over more traditional open procedures include:

  • Improved visualization
  • Decreased postoperative pain
  • Decreased cost as an outpatient procedure vs overnight hospital stay
  • Faster postoperative recovery

Please note: Elbow arthroscopy was initially proposed in 1931, but was not approved at the time due to the high risk of neurovascular injury. Since that time, we have seen vast improvements in our understanding of the complex anatomy of the elbow as well as in the surgical instruments available, and the procedure has become more widespread. However, this is a highly specialized procedure and it is recommended that you speak with your surgeon about his/her training and experience with elbow arthroscopy before opting for surgery.

Dr. Alexander S. Rowland is a board certified orthopaedic surgeon, fellowship trained in conditions of the hand, elbow, and shoulder, with The San Antonio Orthopaedic Group. He treats patients aged 6 years and older for conditions of the hand, wrist, and elbow and has a special interest in elbow arthroscopy, with over 250 cases performed. To schedule an appointment with Dr. Rowland, please call 210.281.9595.


Dr. Richard Ursone on Knee Resurfacing – A New Kind of Knee Replacement (VIDEO)

Posted on

You’ve heard of total knee replacement and partial knee replacement, but a company called Arthrosurface is now offering a new kind of knee replacement implant for a procedure called knee resurfacing. TSAOG joint replacement specialist Dr. Richard L. Ursone sat down with me to discuss the Arthrosurface Femoral Condyle HemiCAP® system.

What is the Arthrosurface Femoral Condyle HemiCAP® system and how does it differ from total knee replacement and partial knee replacement?

 Surgeons look at the knee as having 3 main compartments:

  • Where the femur meets the tibia on the outside of the leg (lateral compartment)
  • Where the femur meets the tibia on the inside of the leg (medial compartment)
  • Where the kneecap (patella) meets the femur

In a total knee replacement, the articular cartilage is damaged over the entire surface of the knee joint, so the damaged area must be removed and replaced in each of the three compartments. This is most often the case with osteoarthritis of the knee, or degenerative joint disease, which we associate with aging.

In a partial (unicompartmental) knee replacement, the articular cartilage is only damaged in one compartment of the knee. This is most often due to post-traumatic arthritis, which is damage to the cartilage that occurs following an injury to the area. In these cases, the surgeon only replaces the damaged compartment of the knee, rather than all three.

The Arthrosurface Femoral Condyle HemiCAP® system is essentially a partial partial knee replacement called knee resurfacing. It is used in cases where damage to the cartilage of the knee is detected only on a small portion of one compartment of the knee. Knee resurfacing replaces only the damaged portion of the knee within the compartment, not the entire compartment.  

Who would be a candidate for this type of knee replacement?
As in the case of partial knee replacement, patients eligible for the knee resurfacing will have cartilage deterioration in the area, most often following an injury, and limited to a small region within one compartment of the knee (on the femur).

Cartilage deterioration tends to affect a smaller area the earlier it is detected, so prospective patients for knee resurfacing also tend to be younger than for other kinds of knee replacement, generally 30-50 years old, and living an active lifestyle. 

How long have you been performing this procedure and what results have you seen?
I have been performing this new procedure for the past year and have been amazed with the results.  I have seen my patients experience excellent pain relief and an early return to full function of the knee.

What are the benefits of knee resurfacing over other knee replacement options?
For the right candidate, knee resurfacing offers several advantages. A smaller incision for a smaller implant means less disruption of the biomechanics of the bones and muscles of the knee, allowing for a faster recovery and return to active lifestyle with little to no restrictions. The minimally invasive procedure can also be performed on an outpatient basis, eliminating costly hospital stays. It also avoids removing bone from the knee, which is required for a traditional unicompartmental knee replacement.

What is your advice for people with persistent knee pain?
Not everyone with persistent knee pain needs a knee replacement, but many people put off seeking treatment because they are afraid that surgery will be their only option. If knee pain is limiting your activities, I urge you to consult a physician to find out what can be done to help. There are many nonsurgical and surgical options available.

If it turns out you do need a knee replacement, early detection of cartilage deterioration can limit the damaged area and affect the kind of replacement you will need.

If you’d like to learn more about knee replacement, visit our knee replacement page.

Dr. Richard L. Ursone is a board certified orthopedic surgeon with The San Antonio Orthopaedic Group. He treats all orthopedic conditions, with the exception of the spine, for patients aged 1 year and up. His special interests include partial knee replacement, knee resurfacing, and arthroscopic knee surgery. To schedule an appointment with Dr. Ursone, please call 210.281.9595 or schedule online.


TSAOG Nominated for AthenaHealth’s 2014 Vision Award (VOTE NOW to Help Us Win)

Posted on

The San Antonio Orthopaedic Group (TSAOG) is one of three nominees for AthenaHealth’s Vision Award, which recognizes companies with a vision that helps “make healthcare work as it should.”

Check out our nomination video, courtesy of AthenaHealth:

Visit to vote for TSAOG (you don’t have to log in or create a password, just click vote!) now through 5pm Wednesday, April 30th to help us win! The winner will be announced on Thursday, May 1st.

Working to “make healthcare work as it should” is one more way TSAOG makes your health our mission.

Dr. Daniel Valdez Demonstrates Joint Replacement Implants on Great Day SA (VIDEO)

Posted on

TSAOG’s Dr. Daniel C. Valdez appeared on Great Day SA‘s Medical Minute on Monday, February 10th, 2014 to discuss the increasing demand for joint replacements in a younger patient population and to demonstrate what joint implants look like for total hip replacement and knee replacement and how they work. If you missed the show live, check out the interview here:

***Video courtesy Great Day SA and AirCheck Productions***

Dr. Daniel C. Valdez is a board certified orthopaedic surgeon with The San Antonio Orthopaedic Group. He treats patients aged 16 years and up for conditions of the hip, knee, and shoulder and has a special interest in total joint replacement. To schedule an appointment with Dr. Valdez, please call 210.281.9595 or schedule online.


TSAOG Customer Survey Highlights – November 2013

Posted on


When our patients have something nice to say about us, we like to brag about it!
Please enjoy some of the highlights from TSAOG’s November 2013 Customer Survey:

  • “Phenomenal! I always feel that I am part of the family at the SA Orthopaedic Group!”
  • “Duane Griffin and his assistant were outstanding. Duane has a comforting and compassionate manner and put me very much at ease.” (OrthoNow Injury Clinic at North Central)
  • “The overall experience is great. The follow up is amazing. It is what every practice should work to provide to customer. I am completely happy with my experience and will refer everyone I can there. You treat people like people.”
  • Dr Kaiser is the most compassionate Dr I believe I have ever encountered. He is so very sweet and understanding.”
  • “Staff is professional and helpful. Physicians spend enough time to answer all my concerns and make me feel my problems are important.” (Dr. Hennessy)
  • Dr. Paul Pace and his two assistants are A++. Lydia and Diana are excellent assistants, and we certainly appreciate them very much.”
  • “The wait time is very short and everyone is always so kind, caring and professional.” (Dr. Gonzalez)
  • “I’m very pleased with your practice.” (Dr. Valdez)
  • “From day one, I have been impressed with the professionalism of the SA Ortho Team. Today I added a surgical team to that.”
  • Dr Marx and staff are exceptional. He was very clear in his findings. Made me feel like i was his only patient of the day.”
  • “I was very pleased with friendly & professional manner of Dr. Seidel and I look forward to working with him.”
  • “Very comfortable ambiance and very warm and friendly down-to-earth sincere staff and physicians that make the overall experience for everyone (even the other patients who are there to converse with) very pleasing.”
  • Dr. Brenman is a careful listener which is greatly appreciated. His suggestions have greatly helped with my pain levels.”
  • “Will always come here for any bone, or joint issues. You all are the best!”
  • “The staff were particularly helpful and pleasant which is always nice when you’re nervous. Dr. Connor was very approachable and I was very comfortable with him. My wait time was very little and the staff were extremely helpful with the forms.”
  • “The urgent care — no appointment needed!” (OrthoNow Injury Clinic)
  • “From my initial visit with Dr Tolin and the staff at the Sonterra office to the pre-op and post-op personnel (physicians, nurses, etc) at Concord, I send my thanks and only positive comments. Hugs all around…Great experience!”
  • “I am thankful Dr Woodbury was able to work with me around my busy work schedule.”
  • “So far, everything about this experience has been positive in every way and far exceeded my expectations. Every member of staff has been professional, helpful, and a credit to the medical field.”
  • “PA Davis Miller has exceptional patient communication skills. Very comfortable communication environment.” (OrthoNow Injury Clinic at Central)
  • “I was very pleased with everything and will recommend y’all to my family members.”
  • Dr Balldin was very helpful and totally concerned with my care.”
  • “Everyone is so helpful & kind – & it is conveniently located.” (Dr. Hibberd)
  • “Keep up the good work. I recommended your services to others.” (Dr. Brown)
  • “I have had both knees replaced and now going to start on my hips. I’m extremely satisfied”
  • “Very efficiently run, I was checked in and was seen by the doctor in a very timely manner.” (Dr. Viroslav)
  • “I feel that I have absolutely the best surgeon for my condition and Dr. Burkhart did a great job of repair on my shoulder.”
  • “I think Dr Bergfeld is wonderful- understanding, empathetic, and knowledgeable.”
  • “Everything very nice and I liked Dr Ochoa, he was very clear on explaining all the different treatment.”
  • Dr. Ursone. My husband and I recommend him to our family, friends and colleagues; they (7) are new patients of his. He is the Best! Takes his time explaining his diagnosis and prognosis. He is on time, his staff clearly respects and likes him. The facility is clean and orderly. Probably the best thing is Everyone smiles and says hello”
  • “Dr. Galindo was extremely professional and personable”
  • “So satisfied with Dr. Drukker’s attention and professionalism. Answered all my questions . He makes me feel comfortable when I go in for my appointments and to me that is very important.”
  • Dr Jacobs is the best! Great personality. Always on time!”
  • “Professional knowledge, courtesy, convenient to get to, staff knowledgeable of procedures, appointments always fit into my schedule.” (Dr. Garcia)
  • Dr. Bell and Sara were very sweet to my 9 year old son. I feel 100% confident in their care.”
  • “I will highly recommend Dr. Rowland
  • “The staff was courteous and professional. I have recommended Dr Taber to my friends and they were very happy with his services too.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.


Subscribe to TSAOG Updates