Arthroscopy comes from the Greek words arthro, meaning “joint,” and skopein, meaning “to look.” Arthroscopic surgery is a minimally invasive technique used by orthopedic surgeons to look inside a joint to diagnose and treat joint problems. You might also hear arthroscopic surgery referred to as a joint scope.
In an arthroscopic procedure, the surgeon inserts the arthroscope, an instrument containing a lens and fiber optic lighting system, through a small incision in the patient’s skin. The arthroscope is then attached to very small television camera, which displays the view from the arthroscope on a television screen in the operating room.
This magnified view allows the orthopedic surgeon to see and explore the interior of the joint to diagnose the severity or type of injury. Initially, arthroscopic surgery was only used as a diagnostic tool, but today many conditions and injuries can also be repaired arthroscopically.
african man suffering from elbow pain; sick black man with elbow joint pain, osteoporosis, bone arthritis, gout, symptoms; body sickness, health care or pain concept; adult african man or model
When the articular cartilage surrounding the ball and socket of your hip joint (where the femur meets the pelvis) is damaged beyond repair, most often due to osteoarthritis (or degenerative joint disease), hip replacement surgery seeks to remove the damaged portion of the hip and replace it with an artificial component.
A total hip replacement (or total hip arthroplasty) involves six main steps:
Preparation of the Hip Socket – The damaged cartilage, as well as a small amount of the bone, is removed from the hip socket (acetabulum) and the new surface is shaped to fit the designated implant.
Preparation of the Femur – The ball at the end of the femur, along with the damaged cartilage, is removed and the hollow center of the femur is reamed to fit the designated femoral stem implant.
Positioning of Hip Socket Implant – A cup-shaped metal implant is positioned in the hip socket. It can be secured with screws or press-fit into place.
Positioning of Femoral Stem Implant – A metal stem is inserted into the femur bone to a depth of around 6 inches. It can be cemented or press-fit into place.
Positioning of Femoral Head – A metal or ceramic ball is positioned on top of the femoral stem, taking the place of the damaged end of the femur, which was removed.
Spacing – A plastic spacer is inserted into the hip socket implant, creating a smooth surface for gliding (acting in place of cartilage for the artificial hip).
The 3 most common approaches are as follows:
Posterior Approach – Posterior approach (also known as the Moore or Southern approach) is the most traditional approach to hip replacement. It involves an incision from the back of the hip joint.
Anterolateral Approach – Anterolateral approach (also known as the Watson-Jones approach) involves accessing the hip from the side.
Anterior Approach – Anterior approach (also known as the Smith-Petersen approach or Direct Anterior Approach (DAA)) involves accessing the hip from the front.
Most patients will stay 2-4 days in the hospital and then begin physical therapy (either with a physical therapist coming to their home or in outpatient physical therapy sessions). Physical therapy progresses from walking with a walker to walking with a cane over the course of 2-3 weeks. Post-operative pain management will be provided through medication and/or injections, but most patients are pain free 2-3 weeks after surgery.
After hip replacement surgery, you can reasonably expect to return to work in an office setting within 2-3 weeks, routine activities like driving within a month, work in an industrial setting involving heavy lifting within 2-3 months, and leisure activities such as golfing and swimming within 3 months.
After recovering from hip replacement, you can expect to live a normal lifestyle, including activities like walking, hiking, biking, hunting, and fishing. Most total hip replacement patients experience a significant reduction in pain as well as a vastly increased ability to perform daily activities.
Dr. Alan E. Hibberd, board-certified orthopedic surgeon, discusses signs that it may be time for you to consider hip replacement and the surgical process.
Dr. Bryan W. Kaiser, board-certified orthopedic surgeon and sports medicine specialist, discusses what to expect from your hip replacement.
Dr. Sergio Viroslav, board-certified orthopedic surgeon, discusses the different surgical approaches to total hip replacement.
The bottom line is that hip replacement surgery is a last resort for dealing with hip pain due to arthritis. However, if you have tried conservative treatment options with no success and persistent arthritic hip pain is interfering with your life and limiting your daily activities, it is time to talk with your doctor about a hip replacement.
Though less common than some other joint replacement procedures, total ankle replacement has the same goal: to increase mobility and alleviate joint pain due to arthritis.
It may be time for you to consider a total ankle replacement if:
You have intense ankle pain that keeps you awake at night or wakes you up.
You have ankle pain that limits your daily activities, like standing, walking, or climbing stairs.
You have noticed weakness and/or decreased range of motion in your ankle.
You have tried conservative treatment options for ankle pain with no success.
When the articular cartilage surrounding your ankle joint (where the tibia meets the talus) is damaged beyond repair, most often due to arthritis that has occurred as a result of the previous injury to the ankle joint, ankle replacement surgery seeks to remove the damaged portion of the ankle joint and replace it with an artificial component to increase range of motion and alleviate ankle pain.
A total ankle replacement (or total ankle arthroplasty) involves 5 main steps:
Preparation of the Tibia – The damaged cartilage, as well as a small amount of the bone, is removed from the bottom of your shin bone (tibia) and the new surface is shaped to fit the designated implant.
Preparation of the Talus – The damaged cartilage, as well as a small amount of the bone, is removed from the top of your ankle bone (talus) and the new surface is shaped to fit the designated implant.
Positioning of Tibia Implant – A metal implant is positioned on the cut end of the tibia and cemented into place.
Positioning of Talus Implant – A metal implant is positioned on the cut end of the talus and cemented into place.
Spacing – A plastic spacer is inserted between the two metal implants to provide a smooth gliding surface, acting in place of cartilage for the artificial ankle.
The bottom line is that ankle replacement surgery is a last resort for dealing with arthritic ankle pain. However, if you have tried conservative treatment options with no success and persistent ankle pain is interfering with your life and limiting your daily activities, it is time to talk with your doctor about an ankle replacement.
Many people delay seeking treatment for joint pain for fear they will be told they need joint replacement surgery. If you suffer from persistent joint pain, you have treatment options. The physicians at TSAOG Orthopaedics & Spine are dedicated to reducing your pain and restoring mobility to your joints. We will evaluate your specific case and discuss your options for treatment. If surgery is recommended, our joint replacement specialists will work with you to ensure the best possible outcome.
Dr. Sergio Viroslav, board-certified orthopedic surgeon, discusses arthritis and your treatment options for joint pain related to arthritis.
What Causes Joint Pain?
Any type of damage to your joints (from injury or disease) can create joint pain and limit your movement. Many different conditions can cause joint pain, including but not limited to:
Sprains and strains
Fractures and other injuries
Conditions like gout and bursitis
Rheumatoid and osteoarthritis
Post-traumatic arthritis (arthritis that develops following a joint injury)
Joint pain is very common and becomes an even more common occurrence as we age. If chronic joint pain is slowing you down, schedule an appointment with an orthopedic specialist to find out what is causing your pain and discuss your treatment options.
No. Because BMAC injections are considered investigational for orthopedic applications, most insurance companies will not cover the cost. Please contact our office to discuss cash payment options.
Fu, Tsai-Sheng, et al, Enhancement of Posterolateral Lumbar Spine Fusion Using Low-Dose rhBMP-2 and Cultured Marrow Stromal Cells, Journal of Orthopaedic Research March 2009, 380-4.
Centeno, Christopher, et al, Regeneration of meniscus cartilage in a knee treated with percutaneously implanted autologous mesenchymal stem cells, Medical Hypotheses (2008) 71, 900–908.
Kovacevic BS, David et al, Biological Augmentation of Rotator Cuff Tendon Repair, Clin Orthop Relat Res (2008) 466:622–633.
Rotini, Roberto et al, New perspectives in rotator cuff tendon regeneration: review of tissue engineered therapies, Chir Organi Mov (2008) 91:87–92.
Tow B., et al, Disc Regeneration: A Glimpse of the Future, 2007 The Congress of 128 Neurological Surgeons.
Chen, Faye, et al, Technology Insight: adult stem cells in cartilage regeneration and tissue engineering, NATURE CLINICAL PRACTICE RHEUMATOLOGY, JULY 2006 VOL 2 NO 7, 373-382.
Zantop, Thore et al, Extracellular Matrix Scaffolds Are Repopulated by Bone Marrow-Derived Cells in a Mouse Model of Achilles Tendon Reconstruction, Journal of Orthopaedic Research June 2006, 1299-1309.
Acosta F., Lotz J., Ames C., et al, The potential role of mesenchymal stem cell therapy for intervertebral disc degeneration: a critical overview, Neurosurg Focus 19 (3):E4, 2005.
Baksh D., et al, Adult mesenchymal stem cells: characterization, differentiation, and application in cell and gene therapy, J. Cell. Mol. Med. Vol 8, No 3, 2004 pp. 301-316.
Crevesten G., et al, Intervertebral Disc Cell Therapy for Regeneration: Mesenchymal Stem Cell Implantation in Rat Intervertebral Discs, Annals of Biomedical Engineering, Vol. 32, No. 3, March 2004 pp. 430–434.
Hicok, K. C., et al, Human adipose-derived adult stem cells produce osteoid in vivo, Tissue Engineering, Vol. 10(3-4), 371-80, 2004.
Javazon, E., Mesenchymal stem cells paradoxes of passaging, Expiremental Hematology, 32(5)- 414-25, 2004.
Loening, A. M., et al, AMIDE: A Free Software Tool for Multimodality Medical Image Analysis, Molecular Imaging, Vol. 2(3), 131-7, 2003.
Heck J., et al, A Classification System for the Assessment of Lumbar Pain in Athletes, Journal of Athletic Training 2000;35(2):204–211.
Kraus, K., Critically sized osteo-periosteal femoral defects: a dog model, Journal of Investigative Surgery, Vol. 12(2), 115-24, 1999.
Hernigou, Philippe et al, Abnormalities in the Bone Marrow of the Iliac Crest in Patients Who Have Osteonecrosis Secondary to Corticosteroid Therapy or Alcohol Abuse, J Bone Joint Surg Am. 1997;79:1047-53.
Nakajima MD, Takashi, et al, Evaluation of Posterolateral Spinal Fusion Using Mesenchymal Stem Cells, SPINE Volume 32, Number 22, pp 2432–2436.
For patients presenting with joint pain due to arthritis, the first step is usually conservative treatment, which includes but is not limited to medication and physical therapy (or a home exercise program).
If conservative treatment is not successful, you will likely proceed to interventional methods, or joint injections. The most common joint injections both seek to alleviate pain and increase range of motion. They are:
Steroid Injections (or Cortisone Shots) – These injections are commonly used to reduce inflammation and provide relief from arthritis and joint pain.
When cartilage deterioration due to osteoarthritis is causing persistent joint pain that interferes with your daily life, it is our goal to restore normal movement and alleviate pain to your joint – be it your shoulder, hip, or knee. Joint preservation refers to the use of nonsurgical or surgical means to preserve a deteriorating joint in order to delay or avoid joint replacement surgery. Every patient is different, so our specialists will customize your joint preservation strategy with you based on your individual situation, taking into account factors such as your age, expectations, level of joint dysfunction, and activity level.
Wrist arthroscopy is a minimally invasive technique that offers orthopedic surgeons the ability to access, navigate, and operate on the wrist joint through very small incisions. TSAOG Orthopaedics & Spine is pleased to offer arthroscopic surgery for the wrist.
What is Wrist Arthroscopy?
Arthroscopic surgery of the wrist (or wrist scope) is a minimally invasive surgical technique which allows the surgeon to access, explore, and operate on the wrist 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, often negating the need for a larger incision (open surgery).
What Wrist Conditions Can Be Treated Arthroscopically?
Wrist arthroscopy can be used to determine the cause of wrist pain (diagnostic arthroscopy), but many wrist conditions and injuries can also be treated arthroscopically, including:
Carpal Tunnel Syndrome
Wrist Fractures
Ganglion Cysts
Ligament Tears
Triangular Fibrocartilage Complex (TFCC) Tears
Please note: arthroscopic surgery can also be used in combination with open surgery for some procedures.
Compared to open surgery (where the surgeon makes a larger incision to access the joint), arthroscopic surgery offers several benefits:
Reduced Pain
Reduce Pain
With smaller incisions and smaller instruments, patients undergoing arthroscopic procedures tend to experience less postoperative pain.
Reduce Cost
Reduce Cost
Arthroscopic surgery can most often be performed on an outpatient basis, without requiring an overnight stay at the hospital. For this reason among others, arthroscopic surgery tends to be less expensive than open surgery.
Faster Recovery
Faster Recovery
Depending on the procedure(s) performed, arthroscopic surgery generally results in a faster recovery period than open surgery.
Improved Visualization
Improved Visualization
Arthroscopic surgery offers the surgeon a magnified and enhanced view of the interior of the joint.
Shoulder arthroscopy is a minimally invasive technique that offers orthopedic surgeons the ability to access, navigate, and operate on the shoulder joint through very small incisions. TSAOG Orthopaedics & Spine is pleased to offer arthroscopic surgery for the shoulder.
What is Shoulder Arthroscopy?
Arthroscopic surgery of the shoulder (or shoulder scope) is a minimally invasive surgical technique which allows the surgeon to access, explore, and operate on the shoulder 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, often negating the need for a larger incision (open surgery).
What Shoulder Conditions Can Be Treated Arthroscopically?
Shoulder arthroscopy can be used to determine the cause of shoulder pain (diagnostic arthroscopy), but many shoulder conditions and injuries can also be treated arthroscopically, including:
Compared to open surgery (where the surgeon makes a larger incision to access the joint), arthroscopic surgery offers several benefits:
Reduced Pain
Reduce Pain
With smaller incisions and smaller instruments, patients undergoing arthroscopic procedures tend to experience less postoperative pain.
Reduce Cost
Reduce Cost
Arthroscopic surgery can most often be performed on an outpatient basis, without requiring an overnight stay at the hospital. For this reason among others, arthroscopic surgery tends to be less expensive than open surgery.
Faster Recovery
Faster Recovery
Depending on the procedure(s) performed, arthroscopic surgery generally results in a faster recovery period than open surgery.
Improved Visualization
Improved Visualization
Arthroscopic surgery offers the surgeon a magnified and enhanced view of the interior of the joint.
Hip arthroscopy is a minimally invasive technique that offers orthopedic surgeons the ability to access, navigate, and operate on the hip joint through very small incisions. TSAOG Orthopaedics & Spine is pleased to offer arthroscopic surgery for the hip.
What is Hip Arthroscopy?
Arthroscopic surgery of the hip (or hip scope) is a minimally invasive surgical technique which allows the surgeon to access, explore, and operate on the hip 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, often negating the need for a larger incision (open surgery).
What Hip Conditions Can Be Treated Arthroscopically?
Hip arthroscopy can be used to determine the cause of hip pain (diagnostic arthroscopy), but many hip conditions and injuries can also be treated arthroscopically, including:
Femoroacetabular Impingement (FAI)
Labral Tears of the Hip
Snapping Hip Syndrome
Loose Bodies in the Hip
Bone Spurs
Iliotibial (IT) Band Syndrome
Hip Bursitis
Tendon Tears
Please note: arthroscopic surgery can also be used in combination with open surgery for some procedures.
Compared to open surgery (where the surgeon makes a larger incision to access the joint), arthroscopic surgery offers several benefits:
Reduced Pain
Reduce Pain
With smaller incisions and smaller instruments, patients undergoing arthroscopic procedures tend to experience less postoperative pain.
Reduce Cost
Reduce Cost
Arthroscopic surgery can most often be performed on an outpatient basis, without requiring an overnight stay at the hospital. For this reason among others, arthroscopic surgery tends to be less expensive than open surgery.
Faster Recovery
Faster Recovery
Depending on the procedure(s) performed, arthroscopic surgery generally results in a faster recovery period than open surgery.
Improved Visualization
Improved Visualization
Arthroscopic surgery offers the surgeon a magnified and enhanced view of the interior of the joint.
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Cyndee White
Director of Human Resources
Cyndee White has worked in Human Resources for many years mainly in the restaurant and adult alcohol beverage industry prior to joining TSAOG in 2020.
Cyndee earned her degree in Human Resources in 2011 and earned her license in 2012 as a Professional in Human Resources. She grew up all over the country, New York and Indiana and settled in Texas in 2003. I guess you would call her a natural Texan now! Cyndee has four kids and four dogs so her life is always busy. She loves football, traveling and swimming or sitting on the back porch and relaxing every now and then.
Why does Cyndee love working for TSAOG? “Because it pushes me out of my comfort zone and allows me to explore new opportunities in an industry, I haven’t previously worked in. The culture and atmosphere are busy, crazy busy, but I wouldn’t change it for the world. I get to meet new people every day, get to help people every day and get to experience healthcare in a new way. I love engaging with my boss, my peers and my team.“
Brandunn J Hernandez
Human Resources Coordinator, joined TSAOG in June 2019.
Brandunn (Pronounced Brand-in) is from the small town of Pharr, located in the Rio Grande Valley of Texas. When he graduated High School, he moved to Houston and met his wife. They went back to the Valley but soon realized San Antonio was where they wanted to call home.
Brandunn started his career in retail, after about 6 years he decided he wanted to make more of a difference and joined the Physical Therapy world. He started with TSAOG as a PT Tech at our ROC location, after about two years he took a leap and joined the HR Team as one of the HR Coordinator’s.
Andrea Vega
Human Resources Manager
Andrea is from Somerset, TX, a small town just south of San Antonio. She completed her undergraduate degree at Colgate University in Hamilton, NY. Four years and a bachelor’s degree later she decided the snow, subzero temperature and lack of Mexican food was just too much for her and she moved back home to San Antonio!
In 2019, she started working for TSAOG as a Reception Specialist at our Mission Trails Clinic. Later, she joined the Human Resources department initially as an HR Assistant but continued her growth to her current role as the Human Resources Manager!
Noah Nicholson
Human Resources Coordinator joined TSAOG September 2021.
Noah is originally from Louisiana, where he went to school and got his bachelor’s degree in Health and Human Performance. In August of 2021 he moved to San Antonio with his wife and began looking for places to work. Not yet being certain of exactly which road he wanted to take; Noah applied to TSAOG to be a Physical Therapy Technician at the Schertz location where he stayed for around 5 months.
Although he enjoyed working at the Schertz location greatly, he realized Physical Therapy was no longer the path he wanted to take. Noah moved into the HR Coordinator role over at the Annex where he now assists in New Hire Onboarding and other administrative duties.
Angela Zendejas
Talent Acquisition Coordinator, joined TSAOG in August 2016 (for the 2nd time).
Angela is a San Antonio native. She originally joined TSAOG in 1998 and left in 2014 to continue her education. After earning a degree from the University of the Incarnate Word in 2015, Angela returned to her TSAOG family. She became part of the Compnow department and became the team lead.
When the position of Talent Acquisition Coordinator became available in February of 2022 Angela was beyond excited for the opportunity to recruit for the company that had always supported her over the years. She felt this was her chance to help grow our TSAOG family.
Angela loves spending time with her family. She has a passion for Art and painting. She also loves making celebration baskets for loved ones and friends.
Being part of the HR department makes it possible to meet and learn more about our employees (aka my TSAOG family) and I am grateful to be part of such a wonderful team.
Ericka LeGrice
Human Resources Generalist, joined TSAOG in July 2018.
Ericka is from a small town called Harlingen; born and raised there. She started working at Kohl’s about 4 years ago and was able to grow into different positions within the company. During that time, she moved to San Antonio in 2017. Since she has moved she has fallen in love with the city of San Antonio and never wants to leave.
In 2018 she started working as a Reception Specialist at the OI location. She immediately fell in love with TSAOG. Everything from the work environment to my coworkers, to decorating for Halloween and decorating for every Holiday for that matter. I knew at that moment I had found my work home.
About a year later Ericka started working as a Human Resource Assistant where she learned so much more about the Company and all the fun stuff TSAOG has to offer. A little while later she transitioned to a Recruiter role as the, “Talent Acquisition Specialist” where she gets to recruit for the surgery center positions and radiography.
